Seborrheic dermatitis Flashcards
What is seborrheic dermatitis?
Chronic dermatitis thought to be caused by an inflammatory reaction related to a proliferation of a normal skin inhabitant (Malassezia furfur)
Which conditions are associated with seborrheic dermatitis?
- Parkinson’s disease
- Immunodeficiency (HIV)
- Seborrhoea
What are the clinical features of seborrheic dermatitis in adults?
- Chronic course with episodic, active phases alternating with inactive, asymptomatic periods
- Ranges from erythematous plaques with patchy scaling
- Scaling/plaques appear as greasy yellow crusts, distributed along areas with hair and oily skin
- Areas prone to seborrheic dermatitis include scalp, forehead/hairline, nasolabial fold, eyebrows, periocular area, cheeks and chin, pre-sternal and interscapular regions, axillae, under breasts, umbilicus, and groin
How should seborrheic dermatitis of the scalp be managed?
- Preparations containing zinc pyrithione and tar
- 2nd line: ketoconazole
- Selenium sulphide and topical corticosteroid may also be useful
How should seborrheic dermatitis of the face and body be managed?
- Topical antifungals: ketoconazole
- Topical steroids - use for short periods
What are the potential complications of seborrheic dermatitis?
- Exacerbation of seborrheic dermatitis may lead to generalised erythroderma
- Secondary bacterial infection
What are the clinical features of seborrheic dermatitis in infants/children?
- Erythematous (or salmon-coloured) scaling plaques –> greasy, yellow, adherent scales
- Pruritis
Where does seborrheic dermatitis typically occur in infants/children?
- Scalp (cradle cap)
- Forehead
- Nose
- External ear
- Umbilical area
- Intertriginous areas
What is the management of seborrheic dermatitis in infants/children?
Based on severity
- Mild-moderate: baby shampoo and baby oils
- Severe: mild topical steroids, e.g. 1% hydrocortisone
*Not much intervention is required as seborrheic dermatitis in children tends to resolve spontaneously by ~8 months old
