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Seborrheic dermatitis
Last reviewed: 23.04.2024
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[Causes of the seborrheic dermatitis
Causes and pathogenesis of seborrheic dermatitis
To date, there is no single point of view on the etiology of seborrheic dermatitis. It was believed that this is a disease of the sebaceous glands that occurs against the background of endocrine and neurotrophic disorders. In recent years, it has been proved that under certain conditions, in particular hypersecretion of the sebaceous glands and immunodeficient conditions, pityrosporal infection (P. Ovale) may be the cause of seborrhea. Eruptions simulating seborrheic dermatitis appear when eating disorders, for example, with a deficiency of zinc and nicotinic acid, as well as Parkinson's disease.
Pathogenesis
Histopathology
Focal para- keratosis, moderately pronounced acanthosis, spongios (intercellular edema), nonspecific inflammation of the dermis are noted. Characterized by the presence of neutrophils in the widened estuaries of hair follicles, in the composition of crusts and scales.
Symptoms of the seborrheic dermatitis
Symptoms of seborrheic dermatitis
The disease is characterized by severe peeling, inflammation of the skin, accompanied by itching. Peeling can be mucoid or large-plate; along with scales, it is often possible to see yellowing of scaly crusts and hemorrhagic crusts formed as a result of scratching. The pathological process can proceed without noticeable inflammation of the skin and manifest only by peeling (dry seborrhea). In other cases, marked inflammation of the skin, which is thick exudative scales and crusts (oily seborrhea, steatoid pityriasis). Sometimes the inflammation spreads to the red border of the lips with the appearance of scales on them, deep painful cracks, hemorrhagic crusts (exfoliative cheilitis). On the skin of the cheeks of the forehead and other areas, papules may appear as a result of infiltration of the erythematous spots on which thick, scaly crusts of yellowish color appear. Expressed hyperkeratosis makes them similar to psoriatic papules (psoriasis seborrhea). In severe cases, seborrheic dermatitis can take a widespread exfoliative character, up to desquamative erythroderma.
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Treatment of the seborrheic dermatitis
Treatment of seborrheic dermatitis
Seborrheic dermatitis is a chronic disease requiring prolonged maintenance therapy. Of the total funds used vitamins (A, C, group B, etc.), antihistamine (tavegil, analergin, zirtek, fenistil, etc.) and hyposensitizing drugs. External therapy consists in the appointment of 2% shampoo with ketocobalase in case of damage to the scalp, 1.5-2.5% ketoconazole cream in the presence of foci of inflammation on the chest and face. In severe cases, along with antimycotics, corticosteroids are used in the form of creams and ointments. The effectiveness of local immunomodulators (Eidel) in the therapy of seborrheic dermatitis was noted.