#Dandruff

Friends today I am discussing about a skin problem known as Seborrheic Dermatitis. What is seborrheic dermatitis? Considered a chronic form of eczema, seborrheic dermatitis appears on the body where there are a lot of oil-producing (sebaceous) glands like the upper back, nose and scalp. The exact cause of seborrheic dermatitis is unknown, although genes and hormones play a role. Microorganisms that live on the skin naturally can also contribute to seborrheic dermatitis. People of any age can develop seborrheic dermatitis including infants (known as “cradle cap”). However, it most commonly affects adults between the ages of 30-60 and infants under 3 months. Seborrheic dermatitis on the chest that shows round, red areas and slight scaling Common triggers for seborrheic dermatitis include: Stress Hormonal changes or illness Harsh detergents, solvents, chemicals and soaps Cold, dry weather Medications such as psoralen, interferon and lithium In general, seborrheic dermatitis is slightly more common in men than in women. Patients with certain diseases that affect the immune system (such as HIV/AIDS and psoriasis) and the nervous system, such as Parkinson’s disease, are also at increased risk of developing seborrheic dermatitis. It can also affect people who have epilepsy, alcoholism, acne, rosacea and mental health issues such as depression and eating disorders. Seborrheic dermatitis is not contagious. What does seborrheic dermatitis look like? Seborrheic dermatitis often appears on the scalp, where symptoms may range from dry flakes (dandruff) to yellow, greasy scales with reddened skin. Patients can also develop seborrheic dermatitis on other oily areas of their body, such as the face, upper chest and back. Seborrheic dermatitis on the sides of nose Seborrheic dermatitis appears in oily skin areas like the side of the nose and causes redness and yellow scale Common symptoms of seborrheic dermatitis include: Redness Greasy, swollen skin White or yellowish crusty flakes Itch and burning Pink-colored patches, most prominent in people with dark skin What causes seborrheic dermatitis? The exact cause of seborrheic dermatitis is unknown, although genes and hormones play a role. Microorganisms such as yeast, that live on the skin naturally can also contribute to seborrheic dermatitis. Unlike many other forms of eczema, seborrheic dermatitis is not the result of an allergy. People of any age can develop seborrheic dermatitis including infants (known as “cradle cap”). It is slightly more common in men than women. People with certain diseases that affect the immune system, such as HIV or AIDS, and the nervous system, such as Parkinson’s disease, are believed to be at an increased risk of developing seborrheic dermatitis. How is seborrheic dermatitis diagnosed? Seborrheic dermatitis can often look like – or even appear with – other skin conditions such as atopic dermatitis and psoriasis. There is no test for diagnosing seborrheic dermatitis. Your doctor will ask about your medical history and also perform a physical examination of your skin. Sometimes, the doctor with scrape a bit of skin, mix it with a chemical and look at it under a microscope to determine if there is a fungal infection. Similarly, a skin biopsy (a procedure in which a small sample of skin is taken) may be required to rule out the other conditions that look like seborrheic dermatitis. If you are experiencing symptoms, make an appointment with your doctor to get the correct diagnosis and treatment. Seborrheic dermatitis treatment Treatment for seborrheic dermatitis focuses on loosening scale, reducing inflammation and swelling, and curbing itch. In mild cases, a topical antifungal cream or medicated shampoo (such as ketoconazole, selenium sulfide, coal tar, and zinc pyrithione) may be enough to control symptoms. Guidelines for treating seborrheic dermatitis include: For the scalp: Alternate between using your regular shampoo and a medicated dandruff shampoo. If you are African American, wash with the medicated shampoo once weekly. Taper off as your symptoms improve. For the body: Wash daily with a gently cleanser that has 2% zinc pyrithione, followed by a moisturizer. To further soften scale, use a cream containing salicylic acid and sulfur or coal tar. In more severe cases, you may receive a prescription for a mild corticosteroid medication to calm the inflammation as well. Use topical corticosteroids only as directed—that is, when the seborrheic dermatitis is actively flaring. In cases where corticosteroids are not appropriate, or when they have been used for a prolonged period, a non-corticosteroid topical medication such as tacrolimus (Protopic) or pimecrolimus (Elidel) may be prescribed. These medications are called topical calcineurin inhibitors (TCIs) and are approved for use by adults and children two years of age or older. Oral antifungal agents may be used in very severe cases. HOMOEOPATHIC REMEDIES FOR SEBORRHEIC DERMATITIS ARSENIC ALBUM 30-Arsenic album is an effective remedy for seborrheic dermatitis in weak persons.It is also suited patients with fair skin. The scalp is covered with white scales which itch intolerably.Circular patches on bare spots are seen. Along with this great anxiety and restlessness is present. KALI SULHURICUM 30- Kali sulphuricum is one of the top remedies for seborrheic dermatitis with yellow scales. There is prominent yellow flakes on the scalp. The scales are sticky in nature, with a moist scalp. Also it is attended with itching. Heat worsens the itching . THUJA OCCIDENTALIS 200-Thuja occ. is another effective medicine for seborrheic dermatitis with white flakes on the scalp. The other prescribing points are dry hair, which may be split at ends and falling of hair. The hair may be dry in such cases. CALCAREA SULPH 30-Calcarea sulph. is prescribed for seborrheic dermatitis when eruptions with yellow pus occurs. Falling of hair also occurs. GRAPHITES 30-Graphites is an effective Homeopathic medicine for seborrheic dermatitis where the scales on the scalp are accompanied by intense itching. The scales reduce after washing, but reappear. A fetid odour on the scalp may also be observed. The scalp may also remain moist and humid. Matting together of the hair or falling of hair are also seen. Apart from the scalp, the scales may also be present on the eyelid margins and behind the ears. NATRUM MURIATICUM 30- Natrum Muriaticum is prescribed for seborrheic dermatitis with a greasy, oily scalp with redness and flakiness. The scalp is covered with white scurfs. Burning sensation on the scalp may also be present. The face is oily, with redness. Acne on the face may also be present along with the above symptoms. PHOSPHORUS 30--Phosphorus is prescribed when flakiness on the scalp is attended with excessive hairfall is occurs. The hair fall in bunches. In some cases, the hair may fall off in spots. This may be accompanied by a severe burning sensation on the scalp. In a few cases, clammy sweat on the scalp may also be present. SANICULA AQUA 200- Sanicula is another effective remedy for seborrheic dermatitis. Scales are covering the scalp. Scales are also seen on the eyebrows, eye lashes etc. Profuse sweat is present on the head. PSORINUM 200-Psorinum is suited to humid seborrheic dermatitis on the scalp which smells badly. Intolerable itching is present. SULPHUR 200- Sulphur is prescribed when well selected remedies fail. Intolerable itching and scratching of scalp. Scratching causes severe burning.

diagnosis and treatment for 8 yr old boy with lesions from birth..

complaining of dandruff with following pictures. dx and rx??

Friends today again I am discussing about a skin. Problem known as Seborrhoeic dermatitis. What is seborrhoeic dermatitis? Seborrhoeic dermatitis is a common, chronic or relapsing form of eczema/dermatitis that mainly affects the sebaceous, gland-rich regions of the scalp, face, and trunk . There are infantile and adult forms of seborrhoeic dermatitis. It is sometimes associated with psoriasis (sebopsoriasis). Seborrhoeic dermatitis is also known as seborrhoeic eczema. Dandruff (also called ‘pityriasis capitis’) is an uninflamed form of seborrhoeic dermatitis. Dandruff presents as bran-like scaly patches scattered within hair-bearing areas of the scalp. What causes seborrhoeic dermatitis? The cause of seborrhoeic dermatitis is not completely understood. It is associated with proliferation of various species of the skin commensal Malassezia, in its yeast (non-pathogenic) form. Its metabolites (such as the fatty acids oleic acid, malssezin, and indole-3-carbaldehyde) may cause an inflammatory reaction. Differences in skin barrier lipid content and function may account for individual presentations. Who gets seborrhoeic dermatitis? Infantile seborrhoeic dermatitis affects babies under the age of 3 months and usually resolves by 6–12 months of age. Adult seborrhoeic dermatitis tends to begin in late adolescence. Prevalence is greatest in young adults and in the elderly. It is more common in males than in females. The following factors are sometimes associated with severe adult seborrhoeic dermatitis: Oily skin (seborrhoea) Familial tendency to seborrhoeic dermatitis or a family history of psoriasis Immunosuppression: organ transplant recipient, human immunodeficiency virus (HIV) infection and patients with lymphoma Neurological and psychiatric diseases: Parkinson disease, tardive dyskinesia, depression, epilepsy, facial nerve palsy, spinal cord injury and congenital disorders such as Down syndrome Treatment for psoriasis with psoralen and ultraviolet A (PUVA) therapy Lack of sleep, and stressful events. What are the clinical features of seborrhoeic dermatitis? Infantile seborrhoeic dermatitis Infantile seborrhoeic dermatitis causes cradle cap (diffuse, greasy scaling on scalp). The rash may spread to affect armpit and groin folds (a type of napkin dermatitis). There are salmon-pink patches that may flake or peel. It is not especially itchy, so the baby often appears undisturbed by the rash, even when generalised. Infantile seborrhoeic dermatitis Adult seborrhoeic dermatitis Seborrhoeic dermatitis affects scalp, face (creases around the nose, behind ears, within eyebrows) and upper trunk. Typical features include: Winter flares, improving in summer following sun exposure Minimal itch most of the time Combination oily and dry mid-facial skin Ill-defined localised scaly patches or diffuse scale in the scalp Blepharitis: scaly red eyelid margins Salmon-pink, thin, scaly, and ill-defined plaques in skin folds on both sides of the face Petal or ring-shaped flaky patches on hair-line and on anterior chest Rash in armpits, under the breasts, in the groin folds and genital creases Superficial folliculitis (inflamed hair follicles) on cheeks and upper trunk Extensive seborrhoeic dermatitis affecting scalp, neck and trunk is sometimes called pityriasiform seborrhoeide. How is seborrhoeic dermatitis diagnosed? Seborrhoeic dermatitis is diagnosed by its clinical appearance and behaviour. As malassezia are a normal component of skin flora, their presence on microscopy of skin scrapings is not diagnostic. Skin biopsy may be helpful but is rarely indicated. Histological findings specific to seborrhoeic dermatitis are superficial perivascular and perifollicular inflammatory infiltrates, psoriasiform hyperplasia, and parakeratosis around follicular openings. What is the treatment for seborrhoeic dermatitis? Treatment of seborrhoeic dermatitis often involves several of the following options. Keratolytics can be used to remove scale when necessary, eg salicylic acid, lactic acid, urea, propylene glycol Topical antifungal agents are applied to reduce malassezia eg ketoconazole, or ciclopirox shampoo or and/or cream. Note, some strains of malassezia are resistant to azole antifungals. Try zinc pyrithione or selenium sulphide Mild topical corticosteroids are prescribed for 1–3 weeks to reduce the inflammation of an acute flare Topical calcineurin inhibitors (pimecrolimus cream, tacrolimus ointment) are indicated if topical corticosteroids are often needed, as they have fewer adverse effects on facial skin. In resistant cases in adults, oral itraconazole, tetracycline antibiotics or phototherapy may be recommended. Low dose oral isotretinoin has also been shown to be effective for severe or moderate seborrhoeic dermatitis. Scalp treatment Medicated shampoos containing ketoconazole, ciclopirox, selenium sulfide, zinc pyrithione, coal tar, and salicylic acid, used twice weekly for at least a month and if necessary, indefinitely. Steroid scalp applications reduce itching, and should be applied daily for a few days every so often. Calcineurin inhibitors such as tacrolimus can be used as steroid alternatives. Coal tar cream can be applied to scaling areas and removed several hours later by shampooing. Combination therapy is often advisable. Face, ears, chest and back Cleanse the affected skin thoroughly once or twice each day using a non-soap cleanser. Apply ketoconazole or ciclopirox cream once daily for 2 to 4 weeks, repeated as necessary. Hydrocortisone cream can also be used, applied up to twice daily for 1 or 2 weeks. Occasionally a more potent topical steroid may be prescribed. Topical calcineurin inhibitors such as pimecrolimus cream or tacrolimus ointment may be used instead of topical steroids. A variety of herbal remedies are commonly used, but their efficacy is uncertain. Management in infants Regular washing of the scalp with baby shampoo or aqueous cream is followed by gentle brushing to clear the scales. GRAPHITES 30-Graphites is an effective Homeopathic medicine for seborrheic dermatitis where the scales on the scalp are accompanied by intense itching. ... NATRUM MURIATICUM 30- Natrum Muriaticum is prescribed for seborrheic dermatitis with a greasy, oily scalp with redness and flakiness. Other homoeopathic medicines can also be given on the basis of totality of symptoms.

47/Female with scaley lesions over the scalp with pus type discharge. No history of dm Attached Image