Seborrhoeic dermatitis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2].

Synonyms and keywords: Seborrheic eczema.

Overview

Seborrhoeic eczema (also known as Seborrheic dermatitis AmE, seborrhea) is a skin disorder affecting the scalp, face, and trunk causing scaly, flaky, itchy, red skin. It particularly affects the sebum-gland rich areas of skin.

Causes

The cause of seborrhoeic dermatitis remains unknown, although many factors have been implicated. The widely present yeast, Malassezia furfur (formerly known as Pityrosporum ovale), is involved,[1][2] as well as genetic, environmental, hormonal, and immune-system factors.[3][4] A suggestion that seborrhoeic dermatitis is an inflammatory response to this yeast has yet to be proven.[5] Those afflicted with seborrhoeic dermatitis have an unfavourable epidermic response to the infection, with the skin becoming inflamed and flaking.

In children, excessive vitamin A intake can cause seborrhoeic dermatitis.[6] Lack of biotin,[7] pyridoxine (vitamin B6)[7][8] and riboflavin (vitamin B2)[7] may also be a cause.

Hair loss

Side effects to inflammation may include temporary hair loss. If severe outbreaks go untreated for long periods of time, permanent hair loss may result due to damaged hair follicles.

Expect two to six months before hair growth may resume.

Physical examination

Gallery

Head
Ear
Neck
Trunk
Extremities
Genitales

Treatments

Medical Therapy

Seborrheic dermatitis

  • Seborrheic dermatitis[9]
  • 1. Antifungal agents
  • Preferred regimen (1): Ketoconazole 2% in shampoo, foam, gel, or cream
  • Scalp: Twice/week for clearance THEN once/week or every other week for maintenance
  • Other areas: From bid to twice/week for clearance THEN from twice/week to once every other week for maintenance
  • Preferred regimen (2): Bifonazole 1% in shampoo or cream
  • Scalp: 3 times/week for clearance
  • Other areas: qd for clearance
  • Preferred regimen (3): Ciclopirox olamine (also called ciclopirox) 1.0% or 1.5% in shampoo or cream
  • Scalp: Twice to 3 times/week for clearance THEN once/week or every 2 week for maintenance
  • Other areas: Twice daily for clearance THEN qd for maintenance
  • 2. Corticosteroids
  • Scalp: Twice weekly in a short- contact fashion (up to 10 min application, then washing)
  • Preferred regimen (5): Desonide 0.05% lotion bid on scalp and other areas
  • 3. Lithium salts

Plant-based treatments

The World Health Organization mentions Aloe vera gel as a yet to be scientifically proven traditional medicine treatment for Seborrhoeic dermatitis.[10]

Related Chapter

References

  1. Hay R, Graham-Brown R (1997). "Dandruff and seborrheic dermatitis: causes and management". Clin Exp Dermatol. 22 (1): 3–6. doi:10.1046/j.1365-2230.1997.d01-231.x. PMID 9330043.
  2. Nowicki R (2006). "[Modern management of dandruff]". Pol Merkur Lekarski. 20 (115): 121–4. PMID 16617752.
  3. Am Fam Physician 2000;61:2703-10,2713-4
  4. Janniger C, Schwartz R (1995). "Seborrheic dermatitis". Am Fam Physician. 52 (1): 149–55, 159–60. PMID 7604759.
  5. Parry M, Sharpe G (1998). "Seborrheic dermatitis is not caused by an altered immune response to Malassezia yeast". Br J Dermatol. 139 (2): 254–63. doi:10.1046/j.1365-2133.1998.02362.x. PMID 9767239.
  6. "MedlinePlus Medical Encyclopedia: Hypervitaminosis A". www.nlm.nih.gov. Retrieved 2008-03-19.
  7. 7.0 7.1 7.2 "Seborrheic Dermatitis: An Overview - July 1, 2006 -- American Family Physician". www.aafp.org. Retrieved 2008-03-19.
  8. "eMedicine - Nutritional Neuropathy : Article by R Andrew Sewell". www.emedicine.com. Retrieved 2008-03-19.
  9. Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL; et al. (2014). "Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America". Clin Infect Dis. 59 (2): 147–59. doi:10.1093/cid/ciu296. PMID 24947530.
  10. "WHO Monographs on Selected Medicinal Plants - Volume 1: Aloe Vera Gel". www.who.int. Retrieved 2008-03-18.
  11. 11.0 11.1 11.2 11.3 11.4 11.5 11.6 "The Green Pharmacy: New Discoveries ... - Google Book Search". books.google.com. Retrieved 2008-03-19.

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