What is the diagnosis and treatment for suberic dermatitis, also known as seborrheic (SEB) dermatitis?

From the Guidelines

Seborrheic dermatitis, also known as suberic dermatitis, should be treated with topical antifungal medications to reduce the amount of yeast present and topical anti-inflammatory medications to reduce inflammation and itch. This condition is characterized by greasy yellowish scaling, itching, and secondary inflammation from Malassezia yeast, and is more pronounced in patients with Down syndrome, HIV infection, and Parkinson's disease 1. The treatment approach involves a combination of topical therapies, including antifungal medications and anti-inflammatory agents, to manage the symptoms and reduce the risk of complications.

Key Considerations

• Seborrheic dermatitis is a common condition affecting the ears, scalp, central face, and other sebaceous areas of the skin 1.
• The condition is often associated with Malassezia yeast, and treatment should focus on reducing the amount of yeast present and alleviating inflammation and itch.
• Topical antifungal medications and anti-inflammatory agents are the primary treatment options for seborrheic dermatitis.
• Gentle skin care and avoidance of harsh soaps and excessive scrubbing can help prevent flare-ups and promote healing.

Treatment Approach

• Topical antifungal medications, such as ketoconazole or clotrimazole, can be used to reduce the amount of yeast present and alleviate symptoms 1.
• Topical anti-inflammatory medications, such as hydrocortisone or tacrolimus, can be used to reduce inflammation and itch.
• Gentle skin care, including the use of mild, non-comedogenic cleansers and oil-free moisturizers, can help promote healing and prevent flare-ups.
• Lifestyle modifications, such as a balanced diet and stress management, can also help prevent flare-ups and promote overall skin health.

From the Research

Diagnosis of Seborrheic Dermatitis

• Seborrheic dermatitis is a clinical diagnosis based on the location and appearance of the lesions 2
• The skin changes are thought to result from an inflammatory response to a common skin organism, Malassezia yeast 2
• The characteristic symptoms - scaling, erythema, and itching - occur most often on the scalp, face, chest, back, axilla, and groin 2

Treatment of Seborrheic Dermatitis

• Treatment with antifungal agents such as topical ketoconazole is the mainstay of therapy for seborrheic dermatitis of the face and body 2
• Anti-inflammatory agents such as topical corticosteroids and calcineurin inhibitors should be used only for short durations due to possible adverse effects 2
• Topical pimecrolimus 1% cream is an effective and well-tolerated treatment for seborrheic dermatitis 3, 4
• Other treatment options include lithium gluconate/succinate, coal tar, salicylic acid, selenium sulfide, sodium sulfacetamide, glycerin, benzoyl peroxide, aloe vera, mud treatment, and phototherapy 5
• Systemic therapy is reserved only for widespread lesions or in cases that are refractory to topical treatment 5
• Injection of Triamcinolone 80 mg diluted with 0.1% normal saline can be effective and efficient for the treatment of seborrheic dermatitis 6

Treatment Response

• Statistically significant reductions in the scores of all parameters were observed at day 7 and day 14 of the study with pimecrolimus 1% cream 3
• The scoring index (SI) decreased by 61.6% after 2 weeks and 88.6% after 4 weeks of treatment with Triamcinolone solution diluted with normal saline 6
• Patient satisfaction was evaluated as "good" to "very good" in 61.67% of patients treated with Triamcinolone solution diluted with normal saline 6