Seborrheic dermatitis in adolescents and adults
- Denis Sasseville, MD, FRCPC
Denis Sasseville, MD, FRCPC
- Professor of Dermatology and Research Coordinator, Division of Dermatology
- McGill University Health Centre
Seborrheic dermatitis is a chronic, relapsing, and usually mild form of dermatitis that occurs in infants and in adults. The severity may vary from minimal, asymptomatic scaliness of the scalp (dandruff) to more widespread involvement. Affected individuals are usually healthy, although seborrheic dermatitis has been associated with human immunodeficiency virus (HIV) infection, Parkinson disease, a number of other neurologic disorders, and use of neuroleptic medications.
This topic will discuss the pathogenesis, clinical manifestations, and management of seborrheic dermatitis in adolescents and adults. The infantile form of seborrheic dermatitis is discussed separately. (See "Cradle cap and seborrheic dermatitis in infants".)
Seborrheic dermatitis has a biphasic incidence, occurring in infants between the ages of 2 weeks and 12 months, and later, during adolescence and adulthood. The prevalence of clinically significant seborrheic dermatitis is approximately 3 percent, with peak prevalence in the third and fourth decades . The actual prevalence is probably much higher when mild cases are included. Men are affected more frequently than women.
The prevalence of seborrheic dermatitis is increased among individuals with HIV in whom it may be a presenting sign. The prevalence has been estimated to be around 35 percent among patients with early HIV infection, and up to 85 percent among patients with AIDS [2,3].
Patients with parkinsonism frequently present with seborrhea (oily skin) and seborrheic dermatitis, both of which may improve with L-dopa therapy [4,5]. (See "Clinical manifestations of Parkinson disease", section on 'Nonmotor symptoms'.)
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- CLINICAL MANIFESTATIONS
- In patients with HIV
- CLINICAL COURSE
- DIFFERENTIAL DIAGNOSIS
- Therapeutic options
- - Topical antifungal agents
- - Topical corticosteroids
- - Topical calcineurin inhibitors
- - Other topical agents
- - Systemic treatments
- Approach to management
- - Seborrheic dermatitis of the scalp
- - Seborrheic dermatitis of the face
- - Seborrheic blepharitis
- - Seborrheic dermatitis of the trunk and intertriginous areas
- - Seborrheic dermatitis in HIV patients
- - Severe or refractory seborrheic dermatitis
- PREVENTION OF RELAPSE
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS