Seborrheic Dermatitis

Basics

Description

  • A common and chronic papulosquamous inflammatory skin disorder
  • Affects all age groups and varies from mild dandruff to extensive adherent scale
  • Found in areas with high concentrations of sebaceous follicles and glands
  • Sharply demarcated yellow to red to brown, greasy, scaling, crusting patches/plaques
  • Periods of remission and exacerbation frequent in adults

Etiology

  • Exact pathogenesis not fully understood
  • Multifactorial with environmental, genetic, hormonal, immunologic, microbial, and nutritional influences
  • Strong association with Malassezia yeasts
  • Complex physiologic response:
    • Immunologic
    • Inflammatory
    • Hyperproliferation
  • Disease flares are common with physical and emotional stress or illness
  • Factors predisposing patients to develop seborrheic dermatitis and more severe or refractory disease:
    • Congestive heart failure
    • Decreased mobility:
      • Parkinson disease
      • Paralysis
      • Stroke
    • Down syndrome (Trisomy 21):
      • Affects >30%
    • Immunocompromised state:
      • HIV/AIDS
      • Immunosuppressive therapy/organ transplant
      • Premature infants
    • Mood disorders including depression
  • Medications known to induce or aggravate seborrheic dermatitis include:
    • Arsenic
    • Auranofin
    • Aurothioglucose
    • Buspirone
    • Carbamazepine
    • Chlorpromazine
    • Cimetidine
    • Ethionamide
    • Gold
    • Griseofulvin
    • Haloperidol
    • Interferon-α
    • Lithium
    • Methoxsalen
    • Methyldopa
    • Phenothiazines
    • Phenytoin
    • Primidone
    • Psoralen
    • Stanozolol
    • Thiothixene
    • Trioxsalen

There's more to see -- the rest of this topic is available only to subscribers.