eMedicine Specialties > Dermatology > Papulosquamous Diseases
Seborrheic Dermatitis: Differential Diagnoses & Workup
Updated: Mar 10, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Differential Diagnoses
Other Problems to Be Considered
Xerotic eczema
Chronic granulomatous disease
Exfoliative erythroderma
Facial chapping
Infectious eczematoid dermatitis
Letterer-Siwe disease
Scaling drug eruptions
Sebopsoriasis
Staphylococcal blepharitis
Tinea amiantacea
Tinea versicolor6
Vitamin B and/or zinc deficiency
Workup
Laboratory Studies
A clinical diagnosis of seborrheic dermatitis is usually made based on a history of waxing and waning severity and by the distribution of involvement upon examination.
Procedures
A skin biopsy may be needed in persons with exfoliative erythroderma, and a fungal culture can be used to rule out tinea capitis.
Histologic Findings
Dermatopathologic findings of seborrheic dermatitis are nonspecific. Hyperkeratosis, acanthosis, accentuated rete ridges, focal spongiosis, and parakeratosis are characteristic. Psoriasis is distinguished by regular acanthosis, thinned rete ridges, exocytosis, parakeratosis, and an absence of spongiosis. Neutrophils may be seen in both diseases.
More on Seborrheic Dermatitis |
| Overview: Seborrheic Dermatitis |
Differential Diagnoses & Workup: Seborrheic Dermatitis |
| Treatment & Medication: Seborrheic Dermatitis |
| Follow-up: Seborrheic Dermatitis |
| Multimedia: Seborrheic Dermatitis |
| References |
| « Previous Page | Next Page » |
References
Groisser D, Bottone EJ, Lebwohl M. Association of Pityrosporum orbiculare (Malassezia furfur) with seborrheic dermatitis in patients with acquired immunodeficiency syndrome (AIDS). J Am Acad Dermatol. May 1989;20(5 Pt 1):770-3. [Medline].
Odom RB. Seborrheic dermatitis in AIDS. J Int Postgrad Med. 1990;2:18-20.
Belew PW, Rosenberg EW, Jennings BR. Activation of the alternative pathway of complement by Malassezia ovalis (Pityrosporum ovale). Mycopathologia. Mar 31 1980;70(3):187-91. [Medline].
Elish D, Silverberg NB. Infantile seborrheic dermatitis. Cutis. May 2006;77(5):297-300. [Medline].
Tajima M, Sugita T, Nishikawa A, Tsuboi R. Molecular analysis of Malassezia microflora in seborrheic dermatitis patients: comparison with other diseases and healthy subjects. J Invest Dermatol. Feb 2008;128(2):345-51. [Medline].
Pontasch MJ, Kyanko ME, Brodell RT. Tinea versicolor of the face in black children in a temperate region. Cutis. Jan 1989;43(1):81-4. [Medline].
Ford GP, Farr PM, Ive FA, Shuster S. The response of seborrhoeic dermatitis to ketoconazole. Br J Dermatol. Nov 1984;111(5):603-7. [Medline].
Green CA, Farr PM, Shuster S. Treatment of seborrhoeic dermatitis with ketoconazole: II. Response of seborrhoeic dermatitis of the face, scalp and trunk to topical ketoconazole. Br J Dermatol. Feb 1987;116(2):217-21. [Medline].
Skinner RB Jr, Noah PW, Taylor RM, et al. Double-blind treatment of seborrheic dermatitis with 2% ketoconazole cream. J Am Acad Dermatol. May 1985;12(5 Pt 1):852-6. [Medline].
Cunha PR. Pimecrolimus cream 1% is effective in seborrhoeic dermatitis refractory to treatment with topical corticosteroids. Acta Derm Venereol. 2006;86(1):69-70. [Medline].
Firooz A, Solhpour A, Gorouhi F, et al. Pimecrolimus cream, 1%, vs hydrocortisone acetate cream, 1%, in the treatment of facial seborrheic dermatitis: a randomized, investigator-blind, clinical trial. Arch Dermatol. Aug 2006;142(8):1066-7. [Medline].
High WA, Pandya AG. Pilot trial of 1% pimecrolimus cream in the treatment of seborrheic dermatitis in African American adults with associated hypopigmentation. J Am Acad Dermatol. Jun 2006;54(6):1083-8. [Medline].
Schwartz RA, Janusz CA, Janniger CK. Seborrheic dermatitis: an overview. Am Fam Physician. Jul 1 2006;74(1):125-30. [Medline].
Cook BA, Warshaw EM. Role of topical calcineurin inhibitors in the treatment of seborrheic dermatitis: a review of pathophysiology, safety, and efficacy. Am J Clin Dermatol. 2009;10(2):103-18. [Medline].
Zisova LG. Fluconazole and its place in the treatment of seborrheic dermatitis--new therapeutic possibilities. Folia Med (Plovdiv). 2006;48(1):39-45. [Medline].
Kligman AM, Marples RR, Lantis LR, McGinley KJ. Appraisal of efficacy of antidandruff formulations. J Soc Cosmet Chem. 1974;225:73-91.
Carr MM, Pryce DM, Ive FA. Treatment of seborrhoeic dermatitis with ketoconazole: I. Response of seborrhoeic dermatitis of the scalp to topical ketoconazole. Br J Dermatol. Feb 1987;116(2):213-6. [Medline].
Waldroup W, Scheinfeld N. Medicated shampoos for the treatment of seborrheic dermatitis. J Drugs Dermatol. Jul 2008;7(7):699-703. [Medline].
Siadat AH, Iraji F, Shahmoradi Z, Enshaieh S, Taheri A. The efficacy of 1% metronidazole gel in facial seborrheic dermatitis: a double blind study. Indian J Dermatol Venereol Leprol. Jul-Aug 2006;72(4):266-9. [Medline].
Faergemann J. Severe seborrheic dermatitis. J Int Postgrad Med. 1990;2:18-20.
Jacobs PH. Seborrheic dermatitis: causes and management. Cutis. 1988;41:182-6.
Leyden JJ. Overview: Pityrosporum and scaling disorders of the scalp. J Int Postgrad Med. 1990;2:5-9.
Leyden JJ, Kligman AM. Dandruff: cause and treatment. Cosmet Toilet. 1979;94:23-28.
Leyden JJ, McGinley KJ, Kligman AM. Role of microorganisms in dandruff. Arch Dermatol. Mar 1976;112(3):333-8. [Medline].
Litt JZ, Powlak WA. Drug Eruption Reference Manual. 5th ed. Cleveland, Ohio: Wal-Zac Enterprises; 1966:465.
Shuster S. The aetiology of dandruff and the mode of action of therapeutic agents. Br J Dermatol. Aug 1984;111(2):235-42. [Medline].
Weary PE. Pityrosporum ovale: observation on some aspects of host-parasite interrelationship. Arch Dermatol. 1968;98:408.
Further Reading
Keywords
seborrheic dermatitis, seborrhea, seborrheic blepharitis, dandruff, Pityrosporum ovale , P ovale, Malassezia, Malassezia ovalis, M ovalis, psoriasis, cradle cap, infantile napkin dermatitis, diaper dermatitis, fungal infection, drug-induced dermatitis, drug-induced seborrhea
Differential Diagnoses & Workup: Seborrheic Dermatitis