11/14/24, 10\:45 AM Seborrhoeic Dermatitis

Seborrhoeic Dermatitis

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Key points ⚡
Succinct notes to superpower your revision
Seborrhoeic dermatitis\: scaly and
1-5% of the world's population.
Aetiology\: exact cause unknown; thought to be an in
‘cradle cap’ in infants; dandru
Risk factors\: psoriasis, immunosuppression (HIV, organ transplant), certain medications (chlorpromazine, haloperidol,
lithium, etc.), neurological conditions (Parkinson's, epilepsy), stress.
Symptoms\: pruritus, blepharitis (gritty, sore, swollen eyelids); important to note past medical history and risk factors.
Clinical examination\: erythematous, greasy scaly patches between eyebrows, around nose creases, behind ears, on scalp;
can also occur in groin and armpit folds.
Di
Investigations\: typically diagnosed via clinical examination; consider HIV testing if rash is widespread.
Management\: responds well to topical treatments; chronic condition requiring repeat treatment; manage in primary care,
refer to dermatologist if severe.
Scalp\: use olive oil, salicylic acid, or coal tar for thick scales; ketoconazole shampoo twice weekly for one month.
Face\: ketoconazole cream daily for up to 4 weeks; add 1% hydrocortisone cream for in
topical calcineurin inhibitors (o
Complications\: secondary bacterial infection of a
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A comprehensive topic overview

Introduction

Seborrhoeic dermatitis is a form of scaly and
typically a
Seborrhoeic dermatitis is a common, benign condition which a
1

Aetiology

The exact aetiology of seborrhoeic dermatitis is unknown. However, it is thought to be an in
yeast, M a l a s s e z i a s p p .
In young infants, seborrhoeic dermatitis can manifest as ‘cradle cap’ which is a widespread greasy scale on the scalp.
Interestingly, dandru

Risk factors

Risk factors for seborrheic dermatitis include\:
1
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Psoriasis
Immunosuppression\: patients with HIV, organ transplant recipients
Medications can trigger the development of seborrhoeic dermatitis (e.g. chlorpromazine, haloperidol, lithium, interferon
alpha, methyldopa, buspirone and griseofulvin)
Neurological conditions such as Parkinson's disease and epilepsy
Stress

Clinical features

History

Typical symptoms of seborrhoeic dermatitis include\:
Pruritus
Blepharitis (if a
Other important areas to cover in the history include\:
Past medical history\: risk factors for developing seborrhoeic dermatitis

Clinical examination

The typical appearance of seborrhoeic dermatitis is erythematous, greasy scaly patches usually between the eyebrows,
around the creases of the nose, behind the ears and on the scalp (Figure 1).
In extensive cases, the patches can also occur in the groin and armpit folds.
Figure 1. An example of seborrhoeic
dermatitis on the scalp.

Di

Seborrhoeic dermatitis can appear similar to the following dermatological conditions, it is especially important to consider
alternative diagnoses if the rash is widespread\:
Rosacea
Psoriasis
Atopic dermatitis

Investigations

Diagnosis is typically made following clinical examination and investigations are not usually required
If the rash is particularly widespread, HIV testing should be considered.

Management

Seborrhoeic dermatitis usually responds well to topical treatment, depending on where the patches manifest will change
the choice of treatment. Patients should be educated that this is a chronic condition and will likely need repeat treatment
in the future.
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Most cases of seborrheic dermatitis can be managed easily in primary care. However, if it is particularly widespread or
severe, a referral should be made to a dermatologist.

Scalp

If thick scales are present, olive oil, salicylic acid or coal tar will need to be used
Following this, ketoconazole shampoo should be used twice weekly for one month.
2

Face

For seborrhoeic dermatitis a
hydrocortisone cream if particularly in
³
Other treatment options include topical calcineurin inhibitors (pimecrolimus cream/tacrolimus ointment). This use is o
licence.
¹

Complications

Seborrhoeic dermatitis is a benign condition. However, secondary bacterial infection of the a

References

Patient Professional. S e b o r r h o e i c D e r m a t i t i s . Last updated March 2022. Available from\: [LINK]
NICE CKS. S e b o r r h o e i c D e r m a t i t i s – M a n a g e m e n t S c a l p a n d B e a r d . Last updated 2022. Available from\: [LINK]
NICE CKS. S e b o r r h o e i c D e r m a t i t i s – M a n a g e m e n t F a c e a n d B o d y . Last updated 2022. Available from\: [LINK]

Image references

Figure 1. Amras666. Seborrhoeic dermatitis. License\: [CC BY-SA]

Reviewer

Dr Thomas King
Consultant Dermatologist

Related notes

Acne vulgaris
Basal Cell Carcinoma (BCC)
Cellulitis
Cutaneous Squamous Cell Carcinoma (SCC)
Erythema Multiforme

Test yourself

Contents

Introduction
Aetiology
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Risk factors
Clinical features
Di
Investigations
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