Seborrheic Dermatitis

Commonly referred to among clinicians as โ€œSeb Derm,โ€ seborrheic dermatitis is a common, poorly understood skin condition which likely has little or nothing to do with sebaceous glands (the latter secrete an oily substance from hair follicles to keep skin hydrated).  A fungus is often considered responsible for Seb Derm, but it may really be the bodyโ€™s inflammatory response to the fungus.  But even if we donโ€™t know what causes Seb Derm, we do know what it looks like.

On the scalp, in its mildest form, it causes dandruff โ€“ fine white scales which flake off, may itch, and are more a cosmetic concern than a disease.  But when more severe, it produces patches of orangish scaly plaques with hair loss.  At the hairline, it might be confused with Psoriasis, which produces silvery white scales.

Seb Derm on the face usually causes scaly patches on the forehead and nasal creases; in men (with more hair follicles), can extend to the mustache area and beard.  It can also occur on the body, mainly in areas where skin touches skin, like the armpits, or under womenโ€™s breasts.

For unknown reasons, Seb Derm can be especially severe in persons with HIV, and older persons with Parkinsonโ€™s Disease.  Anyone with extensive Seb Derm should be tested for the HIV.

Treatment can range from anti-dandruff shampoos for simple cases, to prescription medications with anti-fungals and/or anti-inflammatory agents (steroids and others).  Oral treatment may be required if topical creams and shampoos are unsuccessful.  In such cases, the topical agents can be used afterwards to prevent relapse.

Some pictures of Seborrheic Dermatitis:

On Face / Scalp

emedicine.medscape.com………………………………………………..shutterstock.com……………………………………………………….dermnetnz.org

On Chest

emedicine.medscape.com………………………………………………………………………………………………………dermnetnz.org

Severe Seborrheic Dermatitis in HIV

bestpractice.bmj.com………………………………………………………………………………………….iasusa.org

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