Seborrhoeic dermatitis in adults

Seborrhoeic dermatitis in adults

Seborrhoeic dermatitis in adults is a chronic dermatitis thought to be caused by an inflammatory reaction related to a proliferation of a normal skin inhabitant, a fungus called Malassezia furfur

Malassezia furfur

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(formerly known as Pityrosporum ovale). It is common, affecting around 2% of the general population.

Features

• eczematous lesions on the sebum-rich areas: scalp (may cause dandruff), periorbital, auricular and nasolabial folds
  An itchy rash affecting the face and scalp distribution is commonly caused by seborrhoeic dermatitis
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  Importance: 50
• otitis externa and blepharitis
  Otitis externa and blepharitis are common complications of seborrhoeic dermatitis
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  Importance: 71
  may develop

Associated conditions include

• HIV
  HIV is associated with seborrhoeic dermatitis
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  Importance: 60
• Parkinson's disease
  Parkinson's disease is associated with seborrhoeic dermatitis
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  Importance: 94

Scalp disease management

• the first-line treatment is ketoconazole 2% shampoo
• over the counter preparations containing zinc pyrithione ('Head & Shoulders') and tar ('Neutrogena T/Gel') may be used if ketoconazole is not appropriate or acceptable to the person
• selenium sulphide and topical corticosteroid may also be useful

Face and body management

• topical antifungals: e.g. ketoconazole
  Seborrhoeic dermatitis - first-line treatment is topical ketoconazole
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  Importance: 51
• topical steroids: best used for short periods
• difficult to treat - recurrences are common

+PassMedicine Notes

Seborrhoeic dermatitis in adults is a chronic dermatitis thought to be caused by an inflammatory reaction related to a proliferation of a normal skin inhabitant, a fungus called Malassezia furfur (formerly known as Pityrosporum ovale). It is common, affecting around 2% of the general population.

Features

• eczematous lesions on the sebum-rich areas: scalp (may cause dandruff), periorbital, auricular and nasolabial folds
• otitis externa and blepharitis may develop

Associated conditions include

• HIV
• Parkinson's disease

Scalp disease management

• the first-line treatment is ketoconazole 2% shampoo
• over the counter preparations containing zinc pyrithione ('Head & Shoulders') and tar ('Neutrogena T/Gel') may be used if ketoconazole is not appropriate or acceptable to the person
• selenium sulphide and topical corticosteroid may also be useful

Face and body management

• topical antifungals: e.g. ketoconazole
• topical steroids: best used for short periods
• difficult to treat - recurrences are common