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Seborrhoeic Dermatitis

Disease Details

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Description: Seborrhoeic dermatitis is a chronic inflammatory skin condition characterized by red, scaly, itchy patches, primarily affecting the scalp, face, and upper torso.
Type: Seborrhoeic dermatitis is a chronic inflammatory skin condition. The exact genetic transmission pattern is not clearly defined, but it is believed to involve a complex interplay of genetic and environmental factors, rather than following a simple Mendelian inheritance pattern.
Signs And Symptoms: Seborrhoeic dermatitis typically appears as dry, white, flaky skin. The flakes can be fine, loose, and diffuse or thick and adherent. Additionally, flakes can appear yellow and oily or greasy. In addition to flaky skin, seborrhoeic dermatitis can have areas of red, inflamed, and itchy skin that coincide with the area of skin flaking, but not all individuals have this symptom. seborrhoeic dermatitis of the scalp can appear similarly to dandruff. When the scalp is affected, there can be associated temporary hair loss. Such hair loss varies in appearance from diffuse thinning to patchy areas of hair loss. On close inspection, the locations where hair has thinned may have broken stubs of hair and pustules around the hair follicles. Individuals with more pigmented skin tones may experience increased or decreased skin pigmentation in affected areas.Various locations can be affected by seborrhoeic dermatitis. Commonly affected areas include the face, ears, scalp, and across the body. It is less common in intertriginous areas, which are areas where the skin folds and comes into contact with itself, such as the groin or underarm.Seborrhoeic dermatitis' symptoms are typically mild and appear gradually but are often persistent, lasting weeks to years. Individuals with seborrhoeic dermatitis are subject to recurrent bouts and it may be a lifelong condition. Seborrhoeic dermatitis can also occur quickly and severely in patients with Human Immunodeficiency Virus (HIV). In fact, this is sometimes the first indication of HIV.
Prognosis: The prognosis for seborrhoeic dermatitis is generally good, as it is a chronic but manageable condition. While it may persist for many years with periods of flare-ups and remission, it can usually be controlled with appropriate treatment and lifestyle adjustments. Regular use of medicated shampoos and topical treatments can significantly reduce symptoms. Although there is no cure, individuals can maintain a good quality of life by effectively managing the condition.
Onset: Seborrhoeic dermatitis can begin at any age but commonly appears in infancy as "cradle cap" or during adolescence and adulthood.
Prevalence: Seborrhoeic dermatitis affects approximately 3-5% of the general population, with a higher prevalence in infants and adults aged 30-60.
Epidemiology: Seborrhoeic dermatitis affects 1 to 5% of the general population. It is slightly more common in men, but affected women tend to have more severe symptoms. The condition usually recurs throughout a person's lifetime. Seborrhoeic dermatitis can occur in any age group but often occurs during the first three months of life then again at puberty and peaks in incidence at around 40 years of age. It can reportedly affect as many as 31% of older people. Infants may also have this condition, though it is typically milder, and is referred to as cradle cap. Seborrhoeic dermatitis is more common in African-Americans.Severity is worse in dry climates as well as hot weather as dry skin can exacerbate the condition. COVID-19 related mask usage may also cause or exacerbate facial seborrhoeic dermatitis.Individuals who are immune compromised have increased risk of seborrhoeic dermatitis. Conditions that are associated with increased rates of seborrhoeic dermatitis include individuals with HIV, hepatitis C, alcoholic pancreatitis, Parkinson's disease, and alcohol abuse. Seborrhoeic dermatitis is common in people with alcoholism, between 7 and 11 percent, which is twice the normal expected occurrence.
Intractability: Seborrhoeic dermatitis is generally not considered intractable. It can often be managed effectively through a combination of treatments, including antifungal medications, anti-inflammatory creams, and medicated shampoos. While it can be chronic and recurrent, most individuals achieve good control of symptoms with proper treatment.
Disease Severity: Seborrhoeic dermatitis severity can vary from mild to severe. In its mild form, it may present as minor flaking or dandruff. Moderate cases can include more extensive scaling, redness, and itching. Severe seborrhoeic dermatitis can cause significant inflammation, thick scaly patches, and discomfort, potentially affecting larger areas of the body such as the scalp, face, chest, and back. Severity often fluctuates and can be managed with appropriate treatment.
Healthcare Professionals: Disease Ontology ID - DOID:8741
Pathophysiology: Seborrhoeic dermatitis is a chronic inflammatory skin disorder primarily affecting areas rich in sebaceous glands, such as the scalp, face, and upper body. The exact pathophysiology is not fully understood, but several factors contribute to its development:

1. **Malassezia yeast**: This lipophilic yeast is commonly found on the skin and is thought to play a significant role. Its by-products can cause an inflammatory response in susceptible individuals.

2. **Sebum production**: Increased sebum production creates an environment conducive to the proliferation of Malassezia.

3. **Inflammatory response**: The overgrowth of Malassezia can trigger an immune response, resulting in inflammation and the characteristic symptoms of redness, scaling, and itching.

4. **Genetic factors**: Genetic predisposition may influence the susceptibility and severity of the condition.

5. **Environmental factors**: Stress, weather changes, and certain harsh skin care products can exacerbate the symptoms.
Carrier Status: Seborrhoeic dermatitis is not a condition associated with a carrier status because it is not caused by a single gene mutation that can be carried and passed on through generations like some hereditary conditions. Instead, seborrhoeic dermatitis is a common, chronic inflammatory skin condition influenced by factors such as the presence of Malassezia yeast, sebaceous gland activity, and individual susceptibility.
Mechanism: Seborrhoeic dermatitis is a complex condition with many interacting factors that are not yet fully explained. In general, the major factors that influence the development and severity include Malassezia yeast presents on and in the skin, skin production of oily sebum, and a subsequent inflammatory response against Malassezia and their byproducts. Additional factors involved in the condition are a compromised skin barrier, the makeup and amount of sebum produced, the character of the immune response and inflammation, and the presence of other microbes species inhabiting the skin. A suggested series of events leading to seborrhoeic dermatitis are initial damaged skin barrier and abnormal sebum production which leads to a change in the microbiome of the skin that in turn elicits an immune response. An alternative explanation is an increase in sebum production feeding an increase in the Malassezia population that instigates inflammation; the inflammation then causes cellular changes that damage the skin barrier. This barrier disruption then encourages additional Malassezia growth and inflammation and again worsened skin barrier function.
Treatment: Treatment for seborrhoeic dermatitis typically includes:

1. **Medicated Shampoos:** Shampoos containing ketoconazole, selenium sulfide, zinc pyrithione, or coal tar.
2. **Topical Antifungals:** Creams or lotions with ketoconazole or ciclopirox.
3. **Topical Corticosteroids:** Low-strength corticosteroid creams to reduce inflammation.
4. **Calcineurin Inhibitors:** Pimecrolimus or tacrolimus for sensitive areas like the face.
5. **Moisturizers:** Regular application to affected areas to prevent dryness.
6. **Lifestyle Adjustments:** Reducing stress, maintaining a healthy diet, and practicing good skincare.

Consult a healthcare professional for personalized advice and prescription options.

'NAN' appears not to be relevant in this context.
Compassionate Use Treatment: Seborrhoeic dermatitis is a chronic inflammatory skin condition often affecting the scalp, face, and other areas with sebaceous glands. While the primary treatments include antifungal agents, corticosteroids, and calcineurin inhibitors, there are some off-label and experimental treatments being explored:

1. **Compassionate Use Treatments:**
- This refers to giving access to investigational drugs outside of clinical trials. In seborrhoeic dermatitis, compassionate use is rarely indicated since there are effective treatments available.

2. **Off-Label Treatments:**
- **Tacrolimus and Pimecrolimus:** While primarily indicated for atopic dermatitis, these topical calcineurin inhibitors are often used off-label for seborrhoeic dermatitis, especially in sensitive areas like the face.
- **Metronidazole:** Commonly used for rosacea, metronidazole gel or cream is sometimes applied off-label for seborrhoeic dermatitis.
- **Oral Antifungals:** Itraconazole and fluconazole, although not specifically labeled for seborrhoeic dermatitis, are sometimes used orally in severe cases.

3. **Experimental Treatments:**
- **Biologic Agents:** There is ongoing research into the use of biological drugs, such as those targeting specific inflammatory pathways (e.g., interleukin inhibitors), though this is still in experimental stages.
- **Phototherapy:** Some studies are investigating the efficacy of light therapy, including UVB and narrowband UVB, as a treatment for seborrhoeic dermatitis.

Current treatments largely focus on managing symptoms rather than curing the condition. Always consult healthcare professionals for personalized medical advice.
Lifestyle Recommendations: For seborrhoeic dermatitis, lifestyle recommendations include:

1. **Regular Cleansing**: Wash affected areas with a gentle, non-soap cleanser and warm water. Avoid hot water, which can irritate the skin.

2. **Manage Stress**: Practice stress-reducing activities such as yoga, meditation, or deep-breathing exercises, as stress can exacerbate symptoms.

3. **Dietary Adjustments**: Some individuals find that reducing intake of sugary, fatty, or processed foods helps. Eating a balanced diet rich in fruits, vegetables, and whole grains can support overall skin health.

4. **Scalp Care**: Use anti-fungal shampoo containing ingredients like ketoconazole, selenium sulfide, or zinc pyrithione. Leave the shampoo on for 5-10 minutes before rinsing.

5. **Avoid Skin Irritants**: Stay away from harsh skin and hair care products, as well as alcohol-based or heavily fragranced items.

6. **Moisturize**: Use hypoallergenic moisturizers to keep the skin hydrated, particularly in dry climates or during the winter season.

7. **Wear Breathable Fabrics**: Opt for clothing made of natural fibers like cotton to reduce sweating and irritation.

8. **Limit Alcohol Consumption**: Reducing or eliminating alcohol intake may help improve symptoms for some people.

Regularly following these lifestyle recommendations can help manage and reduce the symptoms of seborrhoeic dermatitis.
Medication: A variety of different types of medications are able to reduce symptoms of seborrhoeic dermatitis. These include certain antifungals, anti-inflammatory agents like corticosteroids and nonsteroidal anti-inflammatory drugs, antiandrogens, and antihistamines, among others. Treatments must take into consideration potential side effects, especially with long-term use given the chronic nature of seborrhoeic dermatitis. Initial therapy is usually a topical preparation with an agreeable side effect profile.
Repurposable Drugs: Seborrhoeic dermatitis may potentially benefit from the repurposing of certain drugs which are originally intended for other conditions. Some of these drugs include:

1. **Antifungal Agents**:
- **Ketoconazole**: Commonly used in shampoos and creams due to its antifungal properties.

2. **Anti-inflammatory Agents**:
- **Corticosteroids**: Such as hydrocortisone or betamethasone, which can reduce inflammation and itching.
- **Calcineurin Inhibitors**: Tacrolimus and pimecrolimus, used topically to reduce inflammation with fewer side effects compared to steroids.

3. **Antibacterial Agents**:
- **Metronidazole**: A topical antibiotic that can help reduce inflammation.

4. **Immunomodulators**:
- **Ciclosporin**: Sometimes used off-label for severe seborrhoeic dermatitis due to its immunosuppressive action.

These treatments are generally used off-label and should be monitored by healthcare professionals for safety and efficacy.
Metabolites: Seborrhoeic dermatitis is associated with altered skin lipid metabolism, resulting in elevated levels of metabolites such as free fatty acids, triglycerides, and cholesterol esters. This condition may also involve changes in the composition of sebum, the oily substance produced by sebaceous glands. Further specific metabolites linked to the condition could include squalene and oleic acid.
Nutraceuticals: Nutraceuticals are foods or food products that provide health benefits beyond basic nutrition. For seborrhoeic dermatitis, certain nutraceuticals may help manage symptoms:

1. Omega-3 fatty acids: Found in fish oil supplements, flaxseeds, and walnuts, these may reduce inflammation.
2. Probiotics: Beneficial bacteria in supplements or fermented foods like yogurt might help balance skin microbiota.
3. Biotin: This B-vitamin, found in foods like eggs and nuts or as a supplement, may improve skin health.
4. Zinc: Available in supplements and foods like seeds and nuts, zinc can help manage skin conditions.

Always consult a healthcare provider before starting any new supplement regimen.
Peptides: Peptides are short chains of amino acids that can have various functions in skincare, including anti-inflammatory and antimicrobial properties. While they are not a primary treatment for seborrhoeic dermatitis, some formulations may include peptides to support skin barrier function and reduce inflammation.

Nanotechnology in skincare involves the use of nanoparticles to deliver active ingredients more effectively. Though not a standard treatment, some research suggests that using nanoparticles can enhance the delivery of antifungal and anti-inflammatory agents to treat seborrhoeic dermatitis, potentially improving outcomes.

Standard treatments for seborrhoeic dermatitis primarily include antifungal agents, corticosteroids, and medicated shampoos containing ingredients like ketoconazole, selenium sulfide, or zinc pyrithione.