Adult Seborrheic Dermatitis

A Status Report on Practical Topical Management

(The Journal of Clinical and Aesthetic Dermatology. 2011; 4 (5) : 3238)

MUHAMMAD RUBAI
09.06.0046

DALAM RANGKA MENGIKUTI KEPANITERAAN

KLINIK
BAGIAN ILMU KULIT DAN KELAMIN
RSU KOTA MATARAM
2016

Abstract
Seborrheic dermatitis is a common chronic-recurrent inflammatory
disorder that most commonly affects adults; however, a more transient
infantile form also occurs. The definitive cause of seborrheic dermatitis
is unknown. However, proliferation of Malassezia species has been
described as a contributing factor. The disorder commonly affects the
scalp, face, and periauricular region, with the central chest, axillae, and
genital region also involved in some cases. Pruritus is not always
present and is relatively common, especially with scalp disease. A
variety of treatments are available including topical corticosteroids,
topical antifungal agents, topical calcineurin inhibitors, and more
recently, a nonsteroidal device cream.

Cont
The reported prevalence of SD in the overall adult population
ranges from 1 to 5 percent, and the disorder can affect any
ethnicity.
Male > Female

Clinical Presentation
Adult SD presents most often on the face and/or scalp as ill-defined
erythematous patches associated with fine (pityriasiform) scaling.
These commonly affected sites include :
scalp
anterior hairline
eyebrows
glabella region
nasal alar creases
melolabial folds
ears
sternum area
genital region.

Etiology
Although the etiology of adult SD is not definitely known, there
are three principal factors that appear to play a role :
Sebaceous gland secretion
Alteration in colonization and metabolism of cutaneous
Individual susceptibility

Management
Shampoo for Scalp
Ketoconazole 2% shampoo or ciclopirox 1% shampoo may be effective as
monotherapy in patients with mild-to-moderate scalp SD.
low potential for irritancy or contact sensitivity.

Nonsteroid Formulations for Scalp

Quicker and greater benefit is more likely with use of a mid-to-highpotency
TCS over a duration of 1 to 2 weeks

Cont
Nonsteroid Formulations for Non-Scalp
For the treatment of mild-to-moderate, adult, non-scalp SD, especially on
facial skin, many patients respond favorably to twice-daily application of a
variety of nonsteroidal therapies

Topical Corticosteroid for Scalp and Non-Scalp

For adult scalp SD, higher potency agents are sometimes needed
especially for diffuse involvement, and or moderate to severe symptoms
such as pruritus, stinging, or burning.

Management
Medication

Frequency

Duration

Ketoconazole 2%
shampoo

Twice/week

4 weeks

Ciclopirox 1% shampoo

Twice/week

4 weeks

Shampoo for Scalp

Other shampoos
Nonsteroid Formulations for Scalp
Ketoconazole 2% foam
Nonsteroid Formulations for Non-Scalp
Antifungal agents :
- Ketoconazole 2%
cream
- Ciclopirox 1% cream

Twice daily
Twice daily

4 weeks
4 weeks

Cont
Medication
Topical calcineurin
inhibitors :
- Pimecrolimus 1%
cream
- Tacrolimus 0.03% and
0.1% ointment

Frequency

Duration

Twice daily

Other Nonsteroid Topical Formulations

NSTD Cream

Twice-thrice daily

Topical Corticosteroid for Scalp and Non-Scalp

TCS

1-2 weeks

Thank You