Seborrheic Dermatitis

Question 1

Seborrheic dermatitis patho

Answer 1

Inflammatory reaction of yeast -> yeast in oil secretion of skin -> immune system overreacts -> inflammation and skin changes

Question 2

Seborrheic dermatitis is most likely to occur in what age of patients and how often?

Answer 2

Biphasic incidence in infants between the ages of 2 weeks and 12 months

Question 3

Manifestations of seborrheic dermatitis

Answer 3

Well-demarcated erythematous plaques, greasy-looking yellowish scales, distributed on areas rich in sebaceous glands (scalp, external ear, center of face, upper part of the trunk, intertriginous areas)

Question 4

Mild form of seborrheic dermatitis

Answer 4

Dandruff

Question 5

Severe form of seborrheic dermatitis

Answer 5

Pityriasis steatites (greasy scales)

Question 6

Seborrheic dermatitis is worse in what conditions?

Answer 6

Stress, cold, dry heat

Question 7

Signs and symptoms of cradle cap

Answer 7

Asymptomatic and non-inflammatory accumulation of greasy scales (may be dark to yellowish) on the scalp

Sometimes the eruption starts on the face, with erythematous, scaly, salmon-colored plaques

Question 8

Where is cradle cap likely to occur on the body?

Answer 8

Forehead, retroauricular areas, eyebrows and eyelids, cheeks, nasolabial folds

Question 9

Treatment for cradle cap

Answer 9

Often resolves on its own, but can use:

• baby shampoo
• removing the scales with a soft brush
• using an emollient cream like mineral oil or petroleum jelly and then using baby shampoo over it

Question 10

Management of seborrheic dermatitis: topical antifungal agents

Answer 10

Ketoconazole 2%, selenium sulfide 2.5%, zinc pyrithione 1% shampoo

Question 11

Selenium sulfide 1%: OTC or Rx and what is the minimum age for patients to use it?

Answer 11

OTC for patients >2 years old

Question 12

Selenium sulfide 2.5%: OTC or Rx and what is the minimum age for patients to use it?

Answer 12

Rx for patients >2 years old

Question 13

Selenium sulfide counseling points for 1%

Answer 13

Massage into the scalp for several minutes and rinse, do this BIW.

Question 14

Selenium sulfide counseling points for 2.5%

Answer 14

Massage into scalp for several minutes and rinse BIW x2 weeks, can go to once a week or less afterward

Question 15

Zinc pyrithione strength and the minimum age to use

Answer 15

1% for patients >2 years old

Question 16

Zinc pyrithione counseling points

Answer 16

Apply to wet hair, massage into scalp for several minutes and rinse

Question 17

Ketoconazole shampoo strength

Answer 17

2%

Question 18

Ketoconazole shampoo counseling points

Answer 18

BIW x4 weeks with at least 3 days in between each treatment, leave in for at least 3 minutes.

Once controlled, it can be used once a week for maintenance

Question 19

Ketoconazole side effects

Answer 19

ALL OF THESE ARE RARE:

Hair loss, skin irritation, abnormal hair texture, dry skin

Question 20

Selenium sulfide side effect

Answer 20

Discoloration of gray, blonde, dyed hair

Question 21

Ciclopirox 1% shampoo counseling points

Answer 21

Use BIW x4 weeks with at least 3 days in between each treatment. Leave in for at least 3 minutes

Same as ketoconazole shampoo!

Question 22

Ciclopirox 0.77% gel counseling points

Answer 22

AAA BID x4 weeks

Question 23

Rare side effect of ciclopirox

Answer 23

Ventricular tachycardia

Question 24

Other treatments for seborrheic dermatitis

Answer 24

• Topical corticosteroids for symptom management
• Topical calcineurin inhibitors
• Systemic antifungals (itraconazole, ketoconazole, fluconazole, terbinafine)
• Coal tar solution