This document discusses seborrheic dermatitis, a chronic papulosquamous skin condition characterized by yellowish, waxy, branny scaling along areas with sebaceous glands like the scalp, face, and trunk. It commonly affects infants under 3 months of age and adults between 40-70 years old. While the exact cause is unknown, factors like sebum production, microbial effects of Malassezia fungi, and genetic and environmental factors may play a role. The document describes the various clinical presentations in infants and adults and treatments involving topical antifungals, corticosteroids, keratolytics, and systemic antifungals.

1. SEBORRHOEIC DERMATITIS

2. SEBORRHOEIC DERMATITIS
 Chronic Papulo-Squamous Dermatitis with
Yellowish, Waxy, Branny Scaling
 Syn : SEBORRHOEIC ECZEMA
 Associated with SEBORRHOEA
 Along distribution of Sebaceous Glands (Primarily
Scalp / Face / Trunk)

3. ETYMOLOGY
 Bimodal Age Incidence
0-3 Months of life
4 th – 7 th Decade of life
 Common in HIV/AIDS & PARKINSONISM
 Men > Women
 03 – 05 % Prevalence

4. ETIOPATHOGENESIS
 EXACT CAUSE UNKNOWN
 SEBORRHOEA
No Sebaceous Gland Pathology
Sebum Production Infancy - Puberty
Retention of Skin Surface Lipids
(Eczema Flanneraire)
 Sebum = ^ CHOLESTEROL / TRIGs
SQUALENE / WAX ESTERS / FFAs
Thought to be an Aberration in
EPIDERMAL PROFILERATION

5. ETIOPATHOGENESIS
 MICROBIAL EFFECTS
 Candida Albicans
 Staphylococcus Aureus Previously
 Propionibacterium Acne

6. ETIOPATHOGENESIS
 Malassezia Furfur (erst Pityrosporum Ovale)
 Lipophilic Yeast / 665,000 Org per sq cm (500,000
in Normal Skin)
 Aggravating > Causative
 T-Cell Activation +/- Complement Activation

7. ETIOPATHOGENESIS
 DRUGS (Gold / Arsenic / Methyl
DOPA)
 SEASONAL PREDILECTION (Winters)
 EMOTIONAL LABILITY / STRESS
 NUTRITIONAL DEFICIENCY (Zn /
BIOTIN)

8. CLINICAL PATTERNS : INFANTS
CRADLE CAP
TRUNCAL LESIONS
LENIER’S DISEASE (FAM / NON-FAM)

9. CLINICAL PATTERN : ADULTS
SCALP
FACE
TRUNK
PETALOID / PITYRIASIFORM /
FLEXURAL
EZCEMATOUS PLAQUES /
FOLLICULAR
GENERALIZED

10. SEBACOUS GLANDS : DISTRIBUTION

11. INFANTILE SEB DERM
 SCALP
Initially Sparse Inflammatory Yellowish, Oily Flakes
Thick Crusted, Grayish-Yellow Scales over an
Erythematous Plaque (Extn beyond Hairline)
without Alopecia - Crusta Lactea / Cradle Cap

12. INFANTILE SEB DERM

13. INFANTILE SEB DERM

14. INFANTILE SEB DERM

15. LEINER’S DISEASE
 Syn : Erythroderma Desquamativum
Dermatitis Seborrhoides Infantum
Discovered by Leiner in 1908
Complication of Infantile Seb Derm with
Confluent Scaly Erythema > 90 % BSA + GI
Manifest + Anemia

16. LEINER’S DISEASE

17. LEINER’S DISEASE

18. DIFFERENTIALS : INF SEB DERM
ATOPIC DERMATITIS
PSORIASIS
SCABIES

19. TREATMENT
SCALP
WARM OIL COMPRESSES
3 % SALICYLIC ACID SHAMPOO /
OIL
DESONIDE LOT 0.05 %
HYDROCORTISONE CREAM 1 %
IMIDAZOLE SHAMPOOS

20. BODY/ INTERTIGO
CLIOQUINOL 0.2 – 0.5% IN Zn
OIL
KETOCONAZOLE 2% CREAM /
SOFTPASTE
DESONIDE LOT 0.05%
TREATMENT

21. ADULT
SEBORRHOEIC
DERMATITIS

22. SCALP IN SEB DERM
 PITYRIASIS SICCA
 PATCHY SEB DERM + CORONA SEBORRHEICA
 PITYRIASIS AMIANTACEA

23. PITYRIASIS SICCA (DANDRUFF)

24. SEB DERM : SCALP
 Perifollicular,
Erythematous Plaques
with Branny Gray-
Yellow, Greasy Scales
 CORONA
SEBORRHOEICA
 May cause reversible
Alopecia

25. PITYRIASIS AMIANTACEA
Syn : Tinea Amiantacea / Asbestos
Scalp
Heavy Micaceous, Crusted Scaling
extending to Follicle
Binding of Proximal Portions of Hair
Assoc with Strep / AD / LS / PSOR

26. PITYRIASIS AMIANTACEA

27. ADULT SEB DERM
Wide Spectrum
SEBORRHOEIC ECZEMATID
Erythema NASOLABIAL /
RETROAURICULAR
Seborrhoea PRESTERNAL / SHOULDER
BLADES
White, Fluffy Scaly Scalp - Pityriasis Sicca
(Dandruff)

28. SEBORRHOEIC ECZEMATID

29. SEB DERM : FACE

30. SEBORRHOEIC BLEPHARITIS

31. SEBORRHOEIC OTITIS EXTERNA

32. SEB DERM : TRUNK

33. SEB DERM : TRUNK

34. SEBORRHOEIC ERYTHRODERMA
Confluent Erythema
Yellowish – Gray Scaling + Exfoliation
Covering > 90 % BSA

35. DIFFERENTIALS : SEB DERM

36. TREATMENT
TOPICALS SELENIUM
 SULFIDE SHAMPOO 1 – 2.5%
 COAL TAR 1-5% OINT / SHAMPOO
 MILD – MODERATE CORTICOSTEROIDS
 DESONIDE LOT 0.05% LOT
 MOMETASONE 0.1 % CR
 FLUCINOLONE ACET 0.01% SH

37. TREATMENT : TOPICALS
ANTIFUNGALS
ZPTO 1-2% SHAMPOO
KETOCONAZOLE 2 % SHAMPOO/
CREAM
CICLOPIROX OLAMINE 1% SH / CR
TERBINAFINE 1% CREAM / SOLUTION
METRONIDAZOLE 1% GEL
KERATOLYTICS (SALICYLIC ACID 5-6% OINT)

38. TREATMENT : TOPICALS
IMMUNOMODULATORS
TACROLIMUS OINT 0.1 %
PIMECROLIMUS OINT 1%
OTHERS - BENZOYL PEROXIDE 2.5 – 5%

39. TREAMENT
SYSTEMIC
KETOCONAZOLE 200MG / DAY X 07D
ITRACONZAOLE 200 MG / DAY X 07D
TERBINAFINE 250 MG OD X 28 D
ISOTRETINOIN

40. Shankar Lal Jat (Ma1501o)