Seborrhoeic Dermatitis

Question 1

Seborrhoeic Dermatitis is a chronic, relapsing skin condition characterised by what 3 features:

Answer 1

1. Erythema (abnormal redness of skin or mucous membranes) and scaling
2. Increased cell turnover rate
3. Inflammatory response

Question 2

What areas does seborrhoeic dermatitis effect?

Answer 2

• SEBUM-RICH areas
  -may indicate inc seb glan activity but unclear as not some people with SD have norm levels

Question 3

What is the common demographic(s) for SD?

Answer 3

-Adults: begin in late adolescents
-Infants: common within 3 months of age

Question 4

Discuss individual susceptibility in SD

Answer 4

-Differences in skin condition (hydration/lipids etc) account for individual presentation

Question 5

Signs and symptoms of Seborrhoeic Dermatitis - Adults

Answer 5

-Flaky, greasy, red patches
-MINIMAL ITCH
-Flares up in winter and improves in summer

Affected areas include:​
-Hair-bearing areas: scalp, eyebrows, moustache, eyelid margins (blepharitis)
-Face: cheeks, nose, nasolabial folds (butterfly rash);​
-Upper back and chest

Question 6

Signs and symptoms of Seborrhoeic Dermatitis - Infants

Answer 6

Varies depending on area:

• SCALP (Cradle cap) – diffuse, greasy, yellowish ​scaling on the scalp
• BOTTOM (Nappy rash) - salmon pink flaky patches, in skin-folds, check for patches on other areas ​
• It sometimes spreads widely via the FLEXURES​

Other features:
-Minimal itch
-Risk of secondary bacterial infection​!!
* Avoid ‘picking’ scales off!​
*Golden yellow – staph infection possible

Question 7

True or False: Seborrhoeic Dermatitis commonly affects adolescent females in hair-bearing areas?

Answer 7

Men are more commonly affected by seborrheic dermatitis than females. Likely something to do with Androgens

Question 8

Are you able to state some distinguishing features between SD and the following conditions?
- Atopic Dermatitis
-Candidiasis
-Psoriasis
-Contact Dermatitis
-Rosacea
-Tinea capitis, corporis

Answer 8

Question 9

What is the first line treatment for SCALP seborrhoeic dermatitis?

Answer 9

Daily standard shampoo until the scalp is clear ​

Question 10

Ruh roh - first line treatment for SCALP seborrhoeic dermatitis didn’t work… whats our second line?

Answer 10

-Anti-yeast shampoo (twice a week to daily-may need to rotate choice of product) e.g. ketoconazole, miconazole, ciclopirox, selenium sulfide, pyrithione zinc, coal tar

Question 11

If (second line) anti-yeast shampoo is ineffective in treating severe seborrhoeic dermatitis - what is our third line?

Answer 11

-ADD following treatments at night and wash off inthe morning:

A corticosteroid lotion for 7 days: bethamethasone diproprionate 0.05%, methylprednisolone aceponate 0.1%, or mometasone furoate 0.1%

+/-

Coal tar 1% emulsion or LPC 3-6% with Salc.Acid in aqueous cream (once or twice weekly)

Question 12

What is our final line of treatment if the third line treatments of sever seborrhoeic dermatitis doesn’t work?

Answer 12

ADD topical corticosteroid shampoo, i.e. clobetasol propionate 0.05%, twice weekly (use anti-yeast shampoo other 5 days)