Seborrhoeic dermatitis , also known as seborrhoea , is a long-term skin disorder. Symptoms include red, scaly, oily, itchy, and inflamed skin. Skin areas rich in oil-producing glands are often affected including the scalp, face, and chest. It can lead to social problems or self-esteem. In infants, when the scalp is primarily involved, it is called a cradle cap. Dandruff is a milder form of the condition, with no associated inflammation.
The cause is unclear but it is believed to involve a number of genetic and environmental factors. Risk factors include poor immune function, Parkinson's disease, epilepsy, and Down syndrome. This condition can worsen with stress or during the winter. It was not a result of poor hygiene. Diagnosis is usually based on symptoms.
Typical treatments are anti-fungal creams and anti-inflammatory agents. Especially ketoconazole or ciclopirox is effective. It is not clear whether other antifungals, such as miconazole, are as effective as they have been poorly studied. Other options may include coal tar and phototherapy.
This condition is most common in those aged around 50 years, during puberty, and among those younger than three months. In adults about 2% of people are affected. Men are more affected than women. Up to 40% of infants may be affected to some extent.
Video Seborrhoeic dermatitis
Signs and symptoms
Symptoms of seborrheic dermatitis appear gradually, and usually the first signs are peeling skin and scalp. The most common symptoms occur in the scalp, behind the ears, in the face, and in areas where the skin is folded. Flakes can be yellow, white or gray. Redness and exfoliation can also occur on the skin near the lashes, on the forehead, around the side of the nose, in the chest, and on the upper back.
In more severe cases, reddish-reddish acne appears along the hairline, behind the ears, in the ear canal, in the eyebrows, on the bridge of the nose, around the nose, in the chest, and on the upper back.
Generally, patients experience mild redness, scaly skin lesions and in some cases hair loss. Other symptoms include uneven or thick scaling of the scalp, red, oily skin covered by yellow or white scales that fly, itch, pain and yellow or white scales that may be attached to the hair shaft.
Seborrhoeic dermatitis can occur in infants younger than three months and leads to thick, oily, yellowish crust around the hairline and on the scalp. Itching is not common among infants. Often, a stubborn diaper rash accompanies a scalp rash. Usually, when it occurs in infants, the condition heals itself within a few days and without treatment.
In adults, symptoms of seborrhoeic dermatitis may last from several weeks to years. Many patients experience periods of intermittent inflammation. This condition is referred to a specialist when self-care proves unsuccessful.
Maps Seborrhoeic dermatitis
Cause
The specific cause is unknown. Current theories for disease causes include weak immune systems, lack of special nutrients or problems with the nervous system.
Mushroom
Seborrhoeic dermatitis may involve an inflammatory reaction to the proliferation of yeast form Malassezia , although this has not been proven.
The main species of yeasts found on their scalp with the condition are Malassezia globosa , others are Malassezia furfur (formerly known as Pityrosporum ovale ) and < i> Malassezia restricta
Only saturated fatty acids (FA) have been shown to support the growth of Malassezia . It has also been shown that while the density numbers of M. globosa and M. restricta are not directly correlated with the presence or severity of dandruff, the deletion is directly correlated with amelioration flakes. Furthermore, in individuals susceptible to pure oleic acid dandruff, unsaturated FA and metabolite Malassezia , induces exfoliation in the absence of Malassezia by a direct effect on the host skin barrier. These findings support the following hypotheses:
Malassezia hydrolyzes human sebum, releasing a mixture of saturated and unsaturated fatty acids. They took the required saturated FA, leaving an unsaturated FA. The unsaturated FA penetrates the stratum corneum. Due to its non-uniform structure, they violate the protective function of the skin. This barrier shield induces an irritant response, which causes dandruff and seborrheic dermatitis.
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Genetic, environmental, hormonal, and immune systems can affect the spread of seborrheic dermatitis. Seborrhoeic dermatitis may be aggravated by illness, psychological stress, fatigue, sleep deprivation, seasonal changes and reduced general health. In children and infants, excessive intake of vitamin A or problems with the delta-6 desaturase enzyme has been correlated with increased risk. Those with immunodeficiency (especially HIV infection) and with neurological disorders such as Parkinson's disease (which is an autonomous sign) and stroke are particularly susceptible to it.
Management
Drugs
A number of drugs can control seborrhoeic dermatitis including: certain antifungies, topical corticosteroids, and keratolytics such as topical urea, as well as antiandrogens and antihistamines.
Antifungi
Daily use of over-the-counter or over-the-counter anti-fungal shampoo may help those with recurring episodes. Topical antifungal drugs ketoconazole and ciclopirox have the best evidence. It is not clear whether other antifungals are as effective as these have not been studied. Another potential option is natural and artificial UV radiation because it can curb the growth of yeast Malassezia
Antiandrogen
Seborrhea is recognized as an androgen-sensitive condition - that is, it is caused or exacerbated by androgen sex hormones such as testosterone and dihydrotestosterone - and is a common symptom of hyperandrogenism (for example, seen in polycystic ovary syndrome). In addition, seborrhoea, as well as acne, is commonly associated with puberty due to the sharp increase in androgen levels at that time.
In accordance with androgen involvement in seborrhea, antiandrogens, such as cyproterone acetate, spironolactone, and flutamide, are highly effective in reducing the condition. Thus, they are used in the treatment of seborrhoea, especially severe cases. Although useful in seborrhea, its effectiveness may vary with different antiandrogens; for example, spironolactone (considered to be a relatively weak antiandrogen) has been found to result in a 50% increase after three months of treatment, while flutamide has been found to result in an 80% increase within three months. Cyproterone acetate is also more potent and effective than spironolactone, and results in repair or loss of acne and seborrhea in 90% of patients within three months.
Systemic antiandrogen therapy should only be used to treat seborrhoea in women, as it may cause feminization (eg, gynecomastia), sexual dysfunction, and male infertility. In addition, antiandrogens theoretically have the potential for feminization of male fetuses in pregnant women, and for this reason, should always be combined with effective contraception in sexually active women who may or may become pregnant.
Antihistamines
Antihistamines are used primarily to reduce itching, if any. However, studies show that some antihistamines have anti-inflammatory properties.
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- Coal can be effective, but, although there is no significant increase in cancer risk in human treatment with coal shampoo found, it is suggested that coal tar is carcinogenic in animals, and heavy human exposure increases the risk of cancer.
- Pimecrolimus topical immunosuppressant cream
- Isotretinoin - As a last resort in refractory disease, the isotretinoin sebotosepresif agent can be used to reduce the activity of the sebaceous glands. However, isotretinoin has serious side effects and some patients with seborrhea are the right candidates for therapy.
Phototherapy
Some recommend photodynamic therapy using UV-A and UV-B lasers or red and blue LED lights to inhibit the growth of the fungus Malassezia and reduce seborrheic inflammation.
Epidemiology
Seborrhoea affects 1 to 5% of the general population. It's slightly more common in men, but the affected women tend to have more severe symptoms. This condition usually repeats throughout a person's life. Seborrhoea can occur in all age groups but usually begins at puberty and peak incidence at around age 40. This can be reported affecting as many as 31% of older people. The severity is worse in dry climates.
See also
- Seborrhoeic keratosis
References
External links
- American Dermatology Academy: seborrheic dermatitis
Source of the article : Wikipedia
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