An inflammatory scaling disease of the scalp, face and occasionally other areas with high density of oil glands (axilla, upper chest, anogenital areas).

Clinical Features

Symptoms develop gradually as:

• Dry or greasy diffuse scaling of scalp (dandruff) with pruritus

• Yellow- red scaling papules in severe cases found along the hairline, external auditory canal, the eye brows, conjunctivitis and in naso-labial folds. Does not cause hair loss.

• Cradle cap (thick yellow crusted scalp) in newborns.

NB: Severe seborrhoeic dermatitis is found in neurologic disorders (Parkinson's disease) and HIV infection.

Management

• Control scaling by 2% salicylic acid in olive oil

• Shampoos containing selenium sulfide, sulfur and salicylic acid, or tar shampoos daily till dandruff is controlled (more recently ketaconazole shampoo is excellent)

• Topical steroids - use mild lotion (e.g. 0.01% fluocinalone acetate)

• Treat superimposed bacterial, fungal or viral infections - which are prevalent in HIV patients

Refer

• Patients who do not respond to treatment.