2nd July 2023

Seborrhoeic Dermatitis

Chronic form of eczema that affects the sebaceous glands primarily on the scalp, face, and trunk. In adults, it results from the proliferation of the skin commensal yeast Malassezia. It typically presents with scale and erythema on the scalp and face, with oily skin affecting the latter. Treatment can be with various agents, which include keratolytics such as salicylic acid to remove scale, topical antifungal agents such as ketoconazole shampoo, and mild topical steroids to reduce inflammation.

Investigations and Management

This is dependent on the presenting features and likely type of eczema. Atopic eczema, as well as pompholyx, are primarily clinical diagnoses. However, patch tests can be performed if contact allergic dermatitis is suspected.

Eczema is managed with emollients and topical corticosteroids. Steroid creams are often used in more acute episodes of irritation as a short course of 5-15 days. The potency of corticosteroids prescribed will depend on the severity and site of the exacerbation. If topical therapies fail, phototherapy, usually with narrowband UVB, can have good results.