SEBORRHEIC DERMATITIS

Dr. Anis Irawan Anwar Sp.KK

Bagian Ilmu Kesehatan Kulit & KelaminFakultas KedokteranUniversitas Hasanuddin

INTRODUCTIONSD chronic superficial inflammatory disease of the skin with a predilection for the scalp, eyebrows, eyelids, nasolabial creases, lips, ears, sternal areas, axillae, umbilicus, groins and gluteal crease. Synonims of Seborrheic Dermatitis (SD) : Dysseborrheic Dermatitis, Unna Disease, Eczema Flainellare

EPIDEMIOLOGISeborrheic dermatitis all races Males > femalesSeborrehic dermatitis neonatus, adults or older peoples.

ETIOLOGYE/ of seborrheic dermatitis unknown.Potensial etiologies of seborrheic dermatitis : stress, weather extremes, oily skin, infrequent shampoos, obesity, strokes, HIVE/ Pityrosporum ovale

PATHOGENESISOver secretion in sebaceous glands predisposition factor.P ovale in the seborrheic area can sensitize an individual resulting in spesific IgG response, can activated complement by both pathways.

CLINICAL MANIFESTATIONThe lesions to be dull or yellowish red in colour had covered with greasy scales.They commonly marginate in hairy skin and involve the scalp, face, sternal and interscapular regions and the flexures.

This a picture of dermatitis seborrheic in infant: scalpThis the picture of dermatitisseborrheic in infants: face.

This a picture of dermatitis seborrheic in infant:bodyThis a picture of seborrheic dermatitis with scales at forehead

This is a picture of seborrheic dermatitis in chest with erythema and scales.

Clinical patterns of seborrheic dermatitis in infantile and adult InfantileScalp (cradle cap)Trunk (including flexures and napkin area)Leiners disease

Adult ScalpDandruffInflammatory may extend onto non hairy areas (e.g. postauricular)Face (may include blepharitis and conjunctivitis)

TrunkPetaloidPityriasiformFlexuralEczematous plaquesFollicularGeneralized (may be erythroderma)

HISTOPATHOLOGYHistological examination subacute dermatitis reaction with spongiosis and even vesicle formation. There is also considerable acanthosis, with elongation and the clubbing of the rete ridges, and there may be some thinning of the supra papillary part of the dermis.

DIAGNOSISThe diagnosis of SD based on assessment of symptoms, accompanied by consideration of medical history, discovery clinical manifestation and histopathology.

DIFFERENTIAL DIAGNOSISThe differential diagnosis of seborrheic dermatitis includes:* psoriasis* pityriasis rosea* tinea* atopic dermatitis

THERAPYInfantsScalp :- salicylic acid 3-5%- hydrocortison 1%- imidazoles-warm olive oil compress- mild baby shampoos- proper skin care with emolients, creams and soft pasts.

Intertriginous areas:- Corticosteroid mild potency- imidazoles preparations (e.g.ketokonazole 2% in soft pastes, creams or lotion)

Adults:Scalp: - frequent shampooing with shampoo containing 1-2,5% selenium sulfida, imidazoles, zinc pyrithione, benzoyl peroxide, salicylic acid.- glucocorticosteroids or salicylic acid in water soluble bases.

If topical treatment fails, we can give:- glucocorticosteroid systemic- antimicrobial treatment

PROGNOSISSeborrheic dermatitis is a chronic condition, controllable with treatment.It often has extended inactive periods followed by flare-ups.

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