© Springer Nature Switzerland AG 2021

P. Treadwell et al. (eds.)Atlas of Adolescent Dermatologyhttps://doi.org/10.1007/978-3-030-58634-8_13

13. Seborrheic Dermatitis

Patricia Treadwell¹  

(1)

Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA

 

 

Patricia Treadwell

Email: ptreadwe@iupui.edu

Keywords

Seborrheic dermatitisMalasseziaPityrosporumKetoconazole

13.1 Introduction

Seborrheic dermatitis is an irritant dermatitis which affects approximately 3% of the population. The sebaceous gland secretions are altered by Malassezia (previously Pityrosporum) species (part of the normal flora) and an irritant dermatitis develops.

13.2 Epidemiology

This chapter focuses on the adolescent and adult populations (not the infantile type). The dermatitis tends to be more widespread in the setting of immunosuppression and underlying neurologic diseases.

13.3 Clinical Findings

Seborrheic dermatitis tends to be noted in areas with more concentrated sebaceous glands including the paranasal and glabellar areas, the eyebrows, and the scalp. Seborrheic dermatitis is characterized by lesions with erythema and yellowish scale – which has been described as “potato chip” scale on an oily background (Fig. 13.1). Itching may be present. Scalp involvement in seborrheic dermatitis consists of diffuse whitish scale (Fig. 13.2).

Fig. 13.1

(a) Seborrheic dermatitis in an adolescent with erythema and scale. (b) Seborrheic dermatitis shows significant improvement with ketoconazole cream for 2 weeks

Fig. 13.2

Whitish scale of the retroauricular area and scalp from seborrheic dermatitis

13.4 Laboratory

The diagnosis is most often made based on the clinical findings.

13.5 Treatment

Topical antifungal creams such as ketoconazole and shampoos have been noted to be effective in seborrheic dermatitis (see Fig 13.1b). Topical corticosteroids or topical calcineurin inhibitors can be a useful adjunct when inflammation is moderate to severe. Although selenium sulfide and zinc pyrithione shampoos have been prescribed for many years, limited evidence exists for their efficacy.

13.6 Prognosis

Seborrheic dermatitis is fairly persistent, but flares can be prevented with continued use of medications.

Suggested Reading

1. Baumert C, et al. Topical medications for seborrheic dermatitis. Am Fam Physician. 2017;95:329.PubMed
2. Clark GW, et al. Diagnosis and treatment of Seborrheic dermatitis. Am Fam Physician. 2015;91:185–90.PubMed