Summary
Definition
Seborrheic dermatitis (SD) is a common inflammatory skin disorder that usually manifests as erythema and scaling of the scalp, nasolabial folds, glabella, and occasionally central face and anterior chest. It tends to worsen with stress.[1] In infants, SD may manifest as scaling of the scalp and is termed cradle cap.[Figure caption and citation for the preceding image starts]: Seborrheic dermatitis, nasolabial fold, with mild scaling and mild erythemaFrom the collection of Robert A. Schwartz, MD, MPH, FACP, FAAD, FRCP (Edin) [Citation ends].
[Figure caption and citation for the preceding image starts]: Seborrheic dermatitis, glabella, with scaling and mild erythemaFrom the collection of Robert A. Schwartz, MD, MPH, FACP, FAAD, FRCP (Edin) [Citation ends].
History and exam
Key diagnostic factors
- scalp itching
- scalp scaling
- glabella scaling
- nasolabial fold scaling
- postauricular scaling
- white flakes
- erythema
Risk factors
- stress
- parkinsonism
- HIV/AIDS
- age <3 months
Diagnostic tests
1st tests to order
- clinical diagnosis
Tests to consider
- skin biopsy
Treatment algorithm
cradle cap in infants
limited to scalp in children and adults
limited to nonscalp area in children and adults
widespread or recalcitrant disease in adults
widespread or recalcitrant disease in children
Contributors
Authors
Camila K. Janniger, MD, FAAD, FRSPH
Clinical Professor
Dermatology
Rutgers New Jersey Medical School
Newark
NJ
Disclosures
CKJ declares that she has no competing interests.
Robert A. Schwartz, MD, MPH, DSc (Hon), FAAD, FRCP (Edin)
Professor of Pathology, Professor of Pediatrics, and Professor of Medicine
Dermatology
Rutgers New Jersey Medical School
Newark
NJ
Disclosures
RAS is the author of several references cited in this topic.
Peer reviewers
Richard Bull, BMBCh
Consultant Dermatologist
Homerton University Hospital NHS Foundation Trust
London
UK
Disclosures
RB declares that he has no competing interests.
David S. Cassarino, MD, PhD
Assistant Professor
Departments of Pathology and Dermatology
UCLA
Los Angeles
CA
Disclosures
DSC declares that he has no competing interests.
Abdulhafez Selim, MD, PhD
Assistant Professor
Biomedical Technology Center
King Fahd University of Petroleum and Minerals
Dhahran
Saudi Arabia
Disclosures
AS declares that he has no competing interests.
Jacek Szepietowski, MD, PhD, FRCP Edin
Professor and Vice Chair
Department of Dermatology, Venereology and Allergology
University of Medicine
Wroclaw
Poland
Disclosures
JS declares he has no competing interests.
References
Key articles
Clark GW, Pope SM, Jaboori KA. Diagnosis and treatment of seborrheic dermatitis. Am Fam Physician. 2015 Feb 1;91(3):185-90.Full text Abstract
Schwartz RA. Superficial fungal infections. Lancet. 2004 Sep 25-Oct 1;364(9440):1173-82. Abstract
Kim TW, Mun JH, Jwa SW, et al. Proactive treatment of adult facial seborrhoeic dermatitis with 0.1% tacrolimus ointment: randomized, double-blind, vehicle-controlled, multi-centre trial. Acta Derm Venereol. 2013 Sep 4;93(5):557-61.Full text Abstract
Diehl C, Ferrari A. Efficacy of topical 4% Quassia amara gel in facial seborrheic dermatitis:a randomized, double-blind, comparative study. J Drugs Dermatol. 2013 Mar;12(3):312-5. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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