Seb Derm Flashcards
seb derm
chronic relapsing skin disorder, scalp, face, trunk, mild dandruff to exfolliative erythroderma, worsens in stress and during cold and dry months
epidemiology
males > females, infants affected resolve by 1 year, peak in adults between 30-40, increase in HIV and parkinsons
patho
malassezia yeast releases inflammatory free fatty acids
clinical features - mild
mild; white, dry, scaling flakes minimal pruritus. no erythema
features - moderate
excessive oil with erythema, visible scale with pruritus impacting daily activities
features - severe
inflammation with fierce erythema, coarse scale and pruritus interferes with sleep
in infants
scalp is cradle cap with thick, greasy scale on the vertex of the scalp
face seb derm
forehead, below hairline, eyebrows, glabella, NL folds, can resemble a butterfly on the cheeks, mustache and beard in men, eyes can get crusted
dx
clinically
ddx
psoriasis, tinea, PR, AD, rosacea
infants
cradle cap is self limiting, wash frequently with mild shampoo to remove scale with a soft brush, small amount of emollient, low potent steroids, keto shampoo
adults
chronic, long term tx may be needed, goal to dx malassezia, topical antifungals, anti-inflamm, oral antifungals
antifungals
ketoconazole 2% bid to clear then daily for maintenance, leave on scalp for 5 min, can also do ciclopirox, otc selenium sulfide otc zinc pyrithione
oral antifungal
for severe - Itraconazole 200mg once daily x 1 week,
antiinflammatory
high potent steroids for no more than 2 weeks, topical cacineurin inhibitors - pimecromilus and tacrolimus – not for children < 2
