seborrheic%20dermatitis
SEBORRHEIC DERMATITIS
Seborrheic dermatitis is a chronic inflammatory skin disorder characterized by fine scaling and erythema mostly confined to areas where sebaceous glands are prominent.
Pityrosporum ovale infection is common in seborrheic dermatitis.
The characteristic pattern is based on age group.
In infants it appears as cradle cap. It is a diffuse or focal scaling and crusting on the vertex of the scalp that sometimes accompanied by inflammation.
In young children, there is Tinea amiantacea which is one or several patches of dense, plate-like scales, 2-10 cm in size that appear anywhere on the scalp.
While adolescents have dandruff which are fine, dry, white, non-inflammatory scalp scaling with minor itching.

Definition

  • A chronic inflammatory skin disorder mostly confined to areas where sebaceous glands are prominent

Etiology

  • Usually caused by inflammatory responses to Malassezia sp proliferation in the stratum corneum
  • Pityrosporum ovale infection is common in seborrheic dermatitis

Signs and Symptoms

  • Have characteristic pattern based on age group

Infants

  • Cradle cap: Diffuse or focal scaling & crusting on the vertex of the scalp sometimes accompanied by inflammation
  • A greasy, scaly, erythematous papular dermatitis may also involve the face, neck, retroauricular areas, axillae & most of the body
  • Flexural folds may be involved, often w/ a cheesy exudate that manifests as a diaper dermatitis that also may become generalized
  • Post-inflammatory pigmentary changes are common
  • Oozing, weeping & pruritus are typically absent
  • Secondary infection can occur
  • May consider Leiner’s disease if lesions becomes widespread & erythrodermic

Young Children

  • Tinea amiantacea: One or several patches of dense, plate-like scales, 2-10 cm in size that appear anywhere on the scalp
  • Persistent lesions can cause temporary hair loss or produce large, oval, yellow-white plates of scale firmly adherent to the scalp & hair

Adolescents (Classic Seborrheic Dermatitis)

  • Dandruff: Fine, dry, white, non-inflammatory scalp scaling w/ minor itching
  • Scalp changes may vary from diffuse, brawny scaling to focal areas of thick, oily, yellow crusts w/ underlying erythema
  • Severe dermatitis manifests as erythema & scaling at the frontal hairline, the medial aspects of the eyebrows & in the nasolabial & retroauricular folds
  • Marginal blepharitis & external auditory canal involvement may be noted
  • Red, scaly plaques may also appear in the axillae, inguinal region, gluteal cleft & umbilicus
  • On the extremities, seborrheic plaques may be more eczematous & less erythematous & demarcated
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