Seborrheic Dermatitis

Diagnosis: Seborrheic Dermatitis

Ill-defined erythematous and scaly lesions on the nasolabial fold .

Clinical Presentation

Ill-defined erythematous and scaly lesions on the nasolabial fold .

Clinical History

Submitted by Alaa Saad. Originally posted October 18, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Psoriasis (scalp) • Atopic dermatitis • Rosacea • Tinea faciei/capitis • Contact dermatitis • Lupus erythematosus • Langerhans cell histiocytosis (infants)

Key Learnings

• Associated with Malassezia yeast — explains response to antifungals • Common distribution: scalp, nasolabial folds, eyebrows, ears, central chest • Severity correlates with Malassezia density, not just presence • More severe in HIV/AIDS and Parkinson disease — consider HIV testing in severe/refractory cases • Cradle cap in infants is the infantile form — generally self-limited • Histology: spongiosis with scale crust ("shoulder parakeratosis") around follicular ostia • Chronic, relapsing condition — maintenance therapy is key

Tags: seborrheic, dermatitis, alaa saad