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Seborrheic DermatitisAka: Seborrhea, Dandruff

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  1. See Also
    1. Pediatric Seborrheic Dermatitis (Cradle Cap)
  2. Causes
    1. Idiopathic
    2. Associated with fungal growth of Malassezia species
      1. Malassezia furfur
      2. Malassezia ovalis
    3. Other associated conditions
      1. Immunodeficiency
      2. Nutritional deficiency
      3. Impaired essential fatty acid metabolism
  3. Symptoms
    1. Greasy, Scaling rash on the face and scalp
    2. Pruritus
  4. Signs
    1. Characteristics
      1. Erythema
      2. Scaling
      3. Greasy or oily skin
    2. Distribution
      1. Common areas
        1. Scalp
        2. Nasolabial fold
      2. Facial involvement
        1. Central face
        2. Beard area
        3. Eyebrows
      3. Chest involvement
        1. Under the breast
        2. Petaloid seborrhea (flower petal-like)
          1. Red-brown Papules with scale
          2. Papules evolve into contiguous patches
        3. Pityriasiform seborrhea (Pityriasis Rosea-like)
          1. Generalized Macules and patches
    3. Associated skin findings
      1. Blepharitis
      2. Otitis Externa
      3. Acne Vulgaris
      4. Pityriasis versicolor
  5. Labs: Biopsy
    1. Scale crust with Neutrophils (perifollicular)
    2. Parakeratosis seen in seborrheic dermatitis due to AIDS
  6. Differential Diagnosis
    1. Acne Rosacea
    2. Atopic Dermatitis
    3. Candidiasis
    4. Dermatophytosis
    5. Langerhans Cell histiocytosis
    6. Psoriasis vulgaris
    7. Systemic Lupus Erythematosus
    8. Tinea Infection
  7. Associated Conditions
    1. Acquired Immunodeficiency Syndrome (AIDS)
    2. Neurologic conditions (Parkinsonism, CVA, Epilepsy)
  8. Management: Anti-inflammatory agents
    1. Topical Corticosteroids
      1. Fluocinolone shampoo applied twice weekly
      2. Other high potency Topical Corticosteroids
        1. Fluocinolone
        2. Betamethasone valerate lotion
      3. Low potency Topical Corticosteroids
        1. Desonide cream
    2. Topical calcineurin Inhibitors
      1. Tacrolimus Ointment
      2. Pimecrolimus cream
  9. Management: Keratolytics
    1. Indicated for scalp or beard area
    2. Directions
      1. Apply 2-3 times weekly
      2. Leave shampoos applied to scalp for 5 minutes
    3. Types
      1. Salicylic acid 2-3% to remove scalp crusts
      2. Tar shampoo
      3. Zinc pyrithione
  10. Management: Antifungals
    1. Ketoconazole 2% (Nizoral) shampoo, gel or cream
      1. Effective for face
      2. Best tolerated
    2. Selenium sulfide 2.5% (Selsun)
    3. Tea Tree Oil Shampoo (5%)
      1. Antifungal activity
      2. Effective and well tolerated
      3. Satchell (2002) J Am Acad Dermatol 47:852
    4. Other anti-fungals
      1. Ciclopirox topically
      2. Fluconazole topically
      3. Oral anti-fungals (Terbinafine) have been used
  11. Management: Combination therapies
    1. Triple cream compounded at pharmacy
      1. Salicylic acid 2%
      2. Hydrocortisone 0.05%
      3. Precipitated Sulfur 3%
    2. Moderate scalp involvement combination
      1. Chloroxine 2% Shampoo apply daily
      2. Flucinolone 0.01% solution apply to scalp qd to bid
  12. References
    1. Danby (1993) J Am Acad Dermatol 29:1008
    2. Gupta (2004) Dermatology 208:89
    3. Scwartz (2006) Am Fam Physician 74:125

Seborrheic dermatitis (C0036508)

Definition (MSH)A chronic inflammatory disease of the skin with unknown etiology. It is characterized by moderate ERYTHEMA, dry, moist, or greasy (SEBACEOUS GLAND) scaling and yellow crusted patches on various areas, especially the scalp, that exfoliate as dandruff. Seborrheic dermatitis is common in children and adolescents with HIV INFECTIONS.
ConceptsDisease or Syndrome (T047)
ICD9690.1, 690.10, 690.10, 706.3
MSHD012628
BasqueBILGORRERI DERMATITIA/ BESTE ZENBAIT DERMATOSI ERITEMATOSO
DanishSeboroisk eksem/an erytem dermat
DutchSeborroisch eczeem/roos
EnglishDERMATITIS SEBORRHEIC, Dermatitis Seborrheica, SBD - Seborrheic dermatitis, SBD - Seborrhoeic dermatitis, SEBORRHEA, Seborrheic Dermatitides, seborrheic dermatitis, Seborrheic eczema, SEBORRHOEA, Seborrhoeic dermatitis, Seborrhoeic eczema, SKIN SEBORRHEIC
FinnishSEBORROINEN EKSEEMA/IHOTTUMA
FrenchDermatite seborrheique
GermanSeborrhoische Dermatitis/Schuppen
Hebrewdermatitis seboreit o kol dermatitis eritematotit-SEBORRHOIC
Hungarianseborrheas dermatitis
ItalianDermatite seborroica
NorwegianSEBOROISK EKSEM/DERMATOSE/FLASS
PortugueseDermatite seborreica
Spanishdermatitis seborreica, eccema seborreico, eccematide seborreica, eczema seborreico, eczematide seborreica, seborrea
SwedishSEBORROISK DERMATIT
Parent ConceptsSebaceous Gland Diseases (C0036502), ECZEMETOUS ABNORMALITIES (C0549659), Erythematosquamous dermatosis NOS (C0014747), Seborrheic dermatitis (C0036508), Diagnosis/Diseases Component (C0497531), Skin (C1123023), Dermatitis (C0011603), Skin Diseases, Eczematous (C0162817), Skin Diseases, Papulosquamous (C0162818), Duplicate concept (C1274013)
SourcesCOSTAR, CSP, CST, DXP, ICD9CM, ICPC, ICPCBAQ, ICPCDAN, ICPCDUT, ICPCFIN, ICPCFRE, ICPCGER, ICPCHEB, ICPCHUN, ICPCITA, ICPCNOR, ICPCPOR, ICPCSPA, ICPCSWE, MSH, MTH, MTHICD9, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Seborrheic dermatitis of scalp (C0221244)

ConceptsDisease or Syndrome (T047)
ICD9690.11
EnglishDANDRUFF, Pityriasis capitis, Pityriasis sicca, SCALP SEBORRHEA, Seborrhea capitis, Seborrhea sicca, Seborrheic dermatitis capitis, Seborrheic dermatitis of scalp, Seborrheic eczema of scalp, Seborrhoea capitis, Seborrhoea sicca, Seborrhoeic dermatitis capitis, Seborrhoeic dermatitis of scalp, Seborrhoeic eczema of scalp
Spanishcaspa, dermatitis seborreica de cuero cabelludo, pitiriasis de la cabeza, pitiriasis seca, seborrea capitis, seborrea de la cabeza, seborrea del cuero cabelludo, seborrea seca
Parent ConceptsSeborrheic dermatitis (C0036508), Pityriasis (C0032024), Ambiguous concept (C1274012), Duplicate concept (C1274013), Exfoliative disorder of skin of scalp (C1302840)
SourcesCOSTAR, DXP, ICD9CM, MTH, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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