Seborrheic dermatitis
Seborrheic dermatitis
Updated: 02/10/2021
© Jun Wang, MD, PhD
General features
- Biphasic incidence, 2 weeks to 12 month, and adolescence/adulthood
- Linked to immunologic abnormalities, and activation of complement
- Alternating with inactive periods
- Active in winter and early spring, remissions in summer
- Usually clinical diagnosis
Pathogenesis
- Malassezia colonization may be associated
- Usually normal levels of Malassezia but abnormal immune response
Clinical features
- Involving scalp, ears, eyebrows, eyelid margin, and nasolabial area, "seborrheic areas"
- Intermittent, active phases of burning, scaling, and itching
- Erythematous scaling papules and plaques, sometimes with a greasy yellow appearance are
- Mild, patchy scaling to widespread, thick, adherent crusts
- Greasy scaling over red, inflamed skin
Pathological features
- Acute lesions: Spongiosis with overlying scale crust centered on a follicle
- Chronic lesions: Pronounced psoriasiform hyperplasia and minimal spongiosis
- Yeast-like organisms usually present
Management
- Treated with anti-inflammatory products
- Anti-seborrheic shampoos helpful
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