Seborrheic dermatitis - a chronic skin disease often observed in patients suffering from seborrhea, more liquid, less dense. Has typical clinical picture and localization of lesions in areas with a large number of sebaceous glands. The skin lesion localized on the scalp and face, especially in the nasolabial folds and cheek in the area of the eyebrows, on the chest in the sternum, back between the shoulder blades and spine. Characterized by the eruption of small follicular nodules point a yellow-pink color, covered with a grayish-yellow, greasy scales. Merging plaques leads to the formation of larger erythematous lesions with scalloped outlines. Severity of disease can vary from small foci to psoriasiform erythroderma. Sometimes at the expense of the central resolution of the lesions is formed ring-shape. Subjectively - itching sensation of light.
The Clinical Picture
There are the following clinical variants of the disease in adults:
Seborrheic Eczematid the easiest form of seborrheic dermatitis, combined with seborrhea, is characterized by flaking, redness and mild itching is often the scalp, eyebrows, nasolabial folds of the buccal and BTE as well as in the middle of the chest and interscapular area.
Spotted Seborrheic Dermatitis the classical form of chronic relapsing. Lesions are located in the middle of the forehead, nasolabial folds cheek, the inside of the eyebrows to the scalp, temples, BTE folds, external auditory canal and middle part of "neckline" chest and back. The defeat of a person usually combined with seborrheic dermatitis of the scalp. Rarely are affected intertriginous areas, such as the neck, axilla and inguinal folds, creases under the breasts, the navel.
The disease begins with a rash of small point-and follicular erythema perifollicular that extend peripheral growth with the formation of clearly defined round, oval plaques. Lesions are characterized by yellowish moderately or highly severe erythema, slight inflammatory infiltration and fatty, thick scales and crusts. Patients worried about itching, especially on the scalp and external auditory canal.
Some patients have one or two of the lesion and sometimes the only manifestation of seborrheic dermatitis can be chronic otitis externa.
Another possible manifestation of blepharitis is a honey-yellow crust on the edges of the eyelids and the accumulation of horny scales around the eyes. In men, there may be a common follicular seborrheic dermatitis, localized on the back sides of the chest and abdomen.
Flow The disease usually occurs within a few years (sometimes decades), improving in the summer and winter sharpening. Significant distribution process may be caused by improper outdoor therapy or insolation. The most serious complication is the occurrence of erythroderma.
Epidemiology Seborrheic dermatitis is more common than psoriasis and there is 2-5% of the population. Men suffer more than women; there are two peaks of the disease, one in the first 3 months of life, and the second in the period from 40 to 70 years. In patients with HIV infection occurs in 40-80% of cases.
Etiology and pathogenesis of seborrheic dermatitis is not clear.
Seborrhea is a predisposing factor to the development of seborrheic dermatitis, seborrheic dermatitis but not a disease of the sebaceous glands.
Partly frequent localization of seborrheic dermatitis is the face, ears, scalp, and upper torso, which is characterized by the presence of a large number of sebaceous glands. In these areas, in addition to seborrheic dermatitis, seborrhea and localizes acne vulgaris.
In people suffering from seborrheic dermatitis, there is a significant increase in the size of sebaceous glands in the histological preparations of the skin. We also identified a biochemical change in the sebum. Seborrheic dermatitis often occurs in patients with Parkinson's disease, which increased secretion of the sebaceous glands.
Microbial Factor Unna and Sabouraud, who first described the disease, believed that the cause of seborrheic dermatitis is bacteria or yeast, or both are together. This hypothesis was not supported, although the bacteria and yeasts isolated from lesions in large quantities.
Malassezia yeast fungi in a large number of scales identified in dandruff and seborrheic dermatitis. Many modern scholars believe these mushrooms are the main etiologic (or pathogenic) factor in seborrheic dermatitis.
Increasing the number of S. aureus and Propionbacterium acne in seborrheic dermatitis is not revealed.
The development of seborrheic dermatitis may contribute to neural factors, such as emotional stress and illnesses such as Parkinson's, facial nerve palsy, polio, myocardial ischemia, malabsorption, epilepsy, obesity, alcoholism, especially alcoholic pancreatitis; seborrheic dermatitis may be a complication of PUVA therapy (This method of treatment by ultraviolet radiation). Seborrheic dermatitis is sometimes called "flannel eczema", believing that the development of the disease plays role items of outer clothing of cotton (flannel), wool or synthetic fabrics. The disease is exacerbated in the winter season, at low temperatures and dryness of the surrounding air.
The skin of patients with seborrheic dermatitis has very high sensitivity to physical and chemical irritation, as well as the development of secondary bacterial dermatitis.
Seborrheic dermatitis in immunodeficiency is very common and has a heavy, widespread over. Seborrheic dermatitis is an early symptom of HIV infection and exacerbation are characteristic progression of immunosuppression.
Treatment of Seborrheic Dermatitis Due to unpredictable long term course of illness, we recommend a careful and gentle treatment: anti-inflammatory drugs, if necessary, antimicrobial and antifungal agents.
Author
Catherine M Quirk, MD (Clinical Assistant Professor, University of Pennsylvania)
Resources
Erin Warshaw, M.D. (Associate Professor, Department Of Dermatology)
Catherine M Quirk, MD (Clinical Assistant Professor, University of Pennsylvania)
Published: 09.10.11
The Clinical Picture
There are the following clinical variants of the disease in adults:
Seborrheic Eczematid the easiest form of seborrheic dermatitis, combined with seborrhea, is characterized by flaking, redness and mild itching is often the scalp, eyebrows, nasolabial folds of the buccal and BTE as well as in the middle of the chest and interscapular area.
Spotted Seborrheic Dermatitis the classical form of chronic relapsing. Lesions are located in the middle of the forehead, nasolabial folds cheek, the inside of the eyebrows to the scalp, temples, BTE folds, external auditory canal and middle part of "neckline" chest and back. The defeat of a person usually combined with seborrheic dermatitis of the scalp. Rarely are affected intertriginous areas, such as the neck, axilla and inguinal folds, creases under the breasts, the navel.
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The disease begins with a rash of small point-and follicular erythema perifollicular that extend peripheral growth with the formation of clearly defined round, oval plaques. Lesions are characterized by yellowish moderately or highly severe erythema, slight inflammatory infiltration and fatty, thick scales and crusts. Patients worried about itching, especially on the scalp and external auditory canal.
Some patients have one or two of the lesion and sometimes the only manifestation of seborrheic dermatitis can be chronic otitis externa.
Another possible manifestation of blepharitis is a honey-yellow crust on the edges of the eyelids and the accumulation of horny scales around the eyes. In men, there may be a common follicular seborrheic dermatitis, localized on the back sides of the chest and abdomen.
Flow The disease usually occurs within a few years (sometimes decades), improving in the summer and winter sharpening. Significant distribution process may be caused by improper outdoor therapy or insolation. The most serious complication is the occurrence of erythroderma.
Epidemiology Seborrheic dermatitis is more common than psoriasis and there is 2-5% of the population. Men suffer more than women; there are two peaks of the disease, one in the first 3 months of life, and the second in the period from 40 to 70 years. In patients with HIV infection occurs in 40-80% of cases.
Etiology and pathogenesis of seborrheic dermatitis is not clear.
Seborrhea is a predisposing factor to the development of seborrheic dermatitis, seborrheic dermatitis but not a disease of the sebaceous glands.
Partly frequent localization of seborrheic dermatitis is the face, ears, scalp, and upper torso, which is characterized by the presence of a large number of sebaceous glands. In these areas, in addition to seborrheic dermatitis, seborrhea and localizes acne vulgaris.
In people suffering from seborrheic dermatitis, there is a significant increase in the size of sebaceous glands in the histological preparations of the skin. We also identified a biochemical change in the sebum. Seborrheic dermatitis often occurs in patients with Parkinson's disease, which increased secretion of the sebaceous glands.
Microbial Factor Unna and Sabouraud, who first described the disease, believed that the cause of seborrheic dermatitis is bacteria or yeast, or both are together. This hypothesis was not supported, although the bacteria and yeasts isolated from lesions in large quantities.
Malassezia yeast fungi in a large number of scales identified in dandruff and seborrheic dermatitis. Many modern scholars believe these mushrooms are the main etiologic (or pathogenic) factor in seborrheic dermatitis.
Increasing the number of S. aureus and Propionbacterium acne in seborrheic dermatitis is not revealed.
The development of seborrheic dermatitis may contribute to neural factors, such as emotional stress and illnesses such as Parkinson's, facial nerve palsy, polio, myocardial ischemia, malabsorption, epilepsy, obesity, alcoholism, especially alcoholic pancreatitis; seborrheic dermatitis may be a complication of PUVA therapy (This method of treatment by ultraviolet radiation). Seborrheic dermatitis is sometimes called "flannel eczema", believing that the development of the disease plays role items of outer clothing of cotton (flannel), wool or synthetic fabrics. The disease is exacerbated in the winter season, at low temperatures and dryness of the surrounding air.
The skin of patients with seborrheic dermatitis has very high sensitivity to physical and chemical irritation, as well as the development of secondary bacterial dermatitis.
Seborrheic dermatitis in immunodeficiency is very common and has a heavy, widespread over. Seborrheic dermatitis is an early symptom of HIV infection and exacerbation are characteristic progression of immunosuppression.
Treatment of Seborrheic Dermatitis Due to unpredictable long term course of illness, we recommend a careful and gentle treatment: anti-inflammatory drugs, if necessary, antimicrobial and antifungal agents.
Author
Catherine M Quirk, MD (Clinical Assistant Professor, University of Pennsylvania)
Resources
Erin Warshaw, M.D. (Associate Professor, Department Of Dermatology)
Catherine M Quirk, MD (Clinical Assistant Professor, University of Pennsylvania)
Published: 09.10.11
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