A 42-year-old female patient attended the Primary Care clinic to receive treatment for a recurrent facial rash. She had previously been diagnosed with psoriasis. The appearance and distribution of the erythematous, flaking rash at her visit was consistent with seborrheic dermatitis; however, the two diseases exist on a spectrum, with mild psoriasis and seborrheic dermatitis sometimes being clinically indistinguishable. Seborrheic dermatitis is a common, chronic skin condition whose exact pathogenesis is not known. It is most likely a multifactorial inflammatory process, at least partially triggered by irritating metabolites of the Malassezia yeast. Immunocompromised hosts are especially susceptible to seborrheic dermatitis. The condition manifests as a pruritic, erythematous, flaking rash with a greasy appearance, and primarily affects the scalp, face, and retroauricular area. Topical antifungals and corticosteroids are the primary treatment modalities for seborrheic dermatitis. The chronicity of the condition often warrants long-term maintenance therapy, which includes over-the-counter shampoos with pyrithione zinc or selenium sulfide, and intermittent mild corticosteroid application. During flares, lesions may be more susceptible to superficial infections as the skin barrier becomes compromised.
KeywordsSeborrhea Seborrheic dermatitis Seborrheic eczema Sebopsoriasis Dandruff Scalp Flaking Scale Psoriasis Inflammation Fungal infection Cradle cap Corticosteroid Antifungal
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