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Dermatitis, seborrheic
What is Seborrheic Dermatitis?
Seborrheic Dermatitis is a chronic inflammatory condition
affecting hairy areas of the body where there are many sebaceous glands, such as
the scalp, eyebrows, and face, especially the nasolabial folds. Other affected
areas include the intertriginous areas, axilla, groin, buttocks, eyelids, chest,
and inframammary folds. It is believed to result from an inflammatory reaction
to Pitysosproum ovale, an otherwise harmless yeast organism. It is
a common problem, affecting 3-5% of health persons. Its incidence
increases sharply in persons with AIDS, in which up to one third of patients are
reported to have seborrheic dermatitis. The condition has periods of flare,
marked by inflammation and variable pruritus, followed by remissions. It's
onset correlates with sebaceous gland activity, occurring during infancy and
after puberty. The condition is related to dandruff, which is scale without
inflammation. The rash of seborrheic dermatitis is a symmetric patch or
plaque with indistinct margins and exhibiting mild to moderate erythema and a
greasy yellowish scale.
With what can it
be confused?
Seborrheic dermatitis can be confused with other causes of
dermatitis, such as atopic dermatitis or
contact dermatitis, psoriasis, fungal
infections of the scalp (tinea capitis), lupus erythematosus, rosacea, and
histiocytosis X.
How is it
diagnosed?
Seborrheic dermatitis is usually diagnosed clinically,
unless the diagnosis is uncertain, in which case investigations are warranted,
such as biopsy to rule out histiocytosis X or lab work for lupus erythematosus.
A history of dandruff is often elicited.
How is it treated?
Shampoos containing selenium sulfide (e.g. Selsun Blue),
zinc pyrithione (e.g. Head & Shoulders), or the antifungal agent ketoconazole
(e.g. Nizoral) are the primary treatments for seborrheic dermatitis. They should
be used three times a week and left in place for several minutes with each
application. If the condition does not respond to these shampoos, a
topical low potency steroid or ketoconazole cream can be tried..
What is the prognosis?
Infantile seborrheic dermatitis usually resolves after 6 to
9 months. In adult seborrheic dermatitis, the course is usually waxing and
waning, but easily managed with the treatments described above.
Date created:
04/05/2007
Last updated:
01/03/2009
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