Seborrhoeic Dermatitis

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Definition: 

An endogenous eczema affecting the scalp and major flexures

Pathogenesis: 

Cause unknown
thought to be due to Pityrisporum yeasts

Clinical features: 

Crusting and weeping of the scalp, ears, eyelid margins, nasolabial folds, neck, axillae, groins.
Anterior chest and upper back may be involved

Infantile variant presents as cradle cap on scalp and pink discoloration of the axillae and groins

Differential diagnosis: nappy dermatitis: limited to area of napkin

Association in adults: HIV

Treatment:

Scalp: 2% Sal acid/ 2% sulphur oint bd
Nizshampoo (ketoconazole)
Stieprox shampoo(cyproxolamine oleate)
Selsun shampoo

Axillae/ groins: 

moderate potency steroid eg Elocon, 1/3 strength Betamethasone valerate (Betnovate)

Trunk: emollient

Severe cases: Ketoconazole orally 1 daily x 1/12


Investigations:

Look for immune suppression in patients presenting with Seb derm.


Seborrhoeic dermatitis in infancy:

 

Scaling of the scalp and pink discoloration of the neck, axillae and groins are characteristic.