Seborrheic dermatitis is a chronic inflammatory pathology that is localized in areas of the body with a large number of sebaceous glands and can significantly impair quality of life patients. It is a clinical diagnosis based on typical lesions and their location. The disease develops both in healthy people and in patients with a weakened immune system of various origins.
Let's talk on estet-portal.com about pathophysiology, clinical diagnosis of pathology and diagnosis by biopsy , modern tactics for managing seborrheic dermatitis.
- Pathophysiology of seborrheic dermatitis: immune response and Malassezia
- Diagnosis of seborrheic dermatitis: clinic, biopsy
- Management of seborrheic dermatitis: skin head, face and body
Pathophysiology of seborrheic dermatitis: immune response and Malassezia
Redness, itching and flaking in seborrheic dermatitis develop due to changes in the functioning of skin cells. The yeast genus Malassezia induces a non-specific immune response that triggers a cascade of skin changes.
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The yeast penetrates the stratum corneum, releasing lipases, which leads to the formation of free fatty acids, and initiates the inflammatory process. Inflammation causes hyperproliferation and incomplete differentiation of corneocytes, disrupting the barrier function and thus further opening access for
, the clinical picture of seborrheic dermatitis is most often represented by scaly, greasy, erythematous lesions on the scalp, skin of the nasolabial folds, ears, eyebrows, anterior surface of the chest and upper third of the back, accompanied by peeling and itching.
Follow us onIt is necessary to differentiate
the disease from a large number of pathologies, however, the typical localization and characteristics of skin lesions allow clinical diagnosis of this pathology.
If clinical diagnosis fails, a biopsy will confirm seborrheic dermatitis by criteria such as parakeratosis in the epidermal layer, plugged follicular orifices, and spongiosis.
Severity of symptoms of seborrheic dermatitis can vary due towith
stress and exposure to sun. Management of seborrheic dermatitis: scalp, face and body
seborrheic dermatitis of the scalp, shampoos containing selenium sulfide, zinc pyrithione, coal tar, tea tree oil should be included in the treatment.
For long-term control of pathology, it is recommended to use
antifungalshampoos containing ketoconazole 2% or ciclopirox 1% daily or 2-3 times a week for several weeks before the start of the remission period. For a full-fledged effect, the composition of the product must be on the hair and scalp for at least 5 minutes. According to studies, preparations containing ketoconazole and zinc do not lose their effectiveness after 3 months of use.
Depending on the severity of scalp inflammation,topical corticosteroids
may be helpful, but long-term use is associated with side effects: fluocinone, betomethasone valerate can reduce itching and inflammation.
Follow us onFacebook! In moderate to severe cases,
clobetasol0.05% shampoo twice weekly, alternating with 2% ketoconazole twice weekly, may reduce symptoms faster and last longer maintain control of seborrheic dermatitis after discontinuation compared to a single drug.
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on the faceand body, topical antifungals, corticosteroids, and calcineurin inhibitors.
should be considered second-line drugs as long-term use is associated with telangiectasias and atrophy of the skin.
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topical calcineurin inhibitorsmay be as effective as topical antifungals and corticosteroids, but have less side effects. FDA warning pimecrolimus and tacrolimus may be associated with lymphoma and skin cancer. Although not enough evidence has been found for this, The American Academy of Dermatology recommends that topical calcineurin inhibitors should be avoided and applied only to limited areas. They should also be considered second-line drugs.
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antifungalsis the mainstay of treatment for seborrheic dermatitis of the scalp, face and body. Due to possible side effects, anti-inflammatory drugs - topical corticosteroids and calcineurin inhibitors - should only be used for a short period of time. Since seborrheic dermatitis is a chronic pathology, supportive care is necessary.
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