Presentation
Case report A 9-year-old girl presented with a five-week history of a progressively worsening, asymptomatic, scaling patch on the scalp. [dpcj.org]
This site is intended for healthcare professionals GP Information Links Trending COVID-19 Red Flags A-Z GP Wellbeing GP Training GP Locums Dr Nigel Stollery compares four presentations and offers clues for their diagnosis including pityriasis rosea, pityriasis [gponline.com]
Presentation[1, 4] Face SD presents as inflamed, greasy areas with fine scaling. The affected areas are: The nasolabial folds. Over the bridge of the nose. The eyelashes/eyebrows. This may present as blepharitis. [patient.info]
RESULTS & CONCLUSION The article summarizes the current knowledge on dandruff and present new facts and evidences in order to spread awareness, create potential for new herbal treatment options, and effectively control the most commercially exploited [unboundmedicine.com]
Entire Body System
- Inflammation
If you suffer from dandruff, common features are flaky white to yellowish scales associated with Itchy scalp, Dry scalp,Inflammation with red scalp. [beautifulmindhealthcare.com]
Inflammation can be characterized by redness, heat, pain, swelling and can cause sensitivity. [en.wikipedia.org]
4=very severe (definite erythema with severe inflammation) 2. [clinicaltrialsregister.eu]
It is named dermatitis because it involves inflammation of the skin and seborrhoeic because it affects areas rich in sebaceous glands. Therefore, it is most common on the face, scalp and chest. It can affect any age from puberty onwards. [patient.info]
Washable leave-on creams or wash-off shampoos containing salicylic acid, coal tar and sulphur may be of help in reducing the scaling and inflammation, e.g. coconut compound ointment. [dermnetnz.org]
- Candidiasis
Candidiasis. Management[1, 7] The basis of treatment is regular antifungal medication with intermittent topical steroids. There is no evidence of superiority of one antifungal over another[8]. [patient.info]
In the case of dermatophytosis and candidiasis, the role of hormones are well known. [10] Studies have shown that testosterone stimulates the growth of certain dermatophytes, while estrogen inhibits the same. [11] The in vitro findings also correlate [ijtrichology.com]
The scrotum itself is usually spared in tinea cruris, but involved in candidiasis. [aafp.org]
Gastrointestinal
- Nausea
Itraconazole is generally well tolerated with minor adverse effects of nausea, headache and abdominal pain being reported in a few patients. [nps.org.au]
Symptoms include: tiredness, nausea, fever, joint ache or pain, lymph node swelling and headache. Pruritis (itching) is often present. Causes PR is classified as idiopathic. Viral infection (herpes 6 and 7) is suspected. [hairscientists.org]
- Vomiting
The most common adverse effects are nausea, anorexia and vomiting occurring in about 20% of patients. Adrenal or testicular steroid metabolism may be affected. [nps.org.au]
Leiner’s disease is a severe, widespread, erythrodermic form of infantile seborrheic dermatitis in which patients have symptoms of fever, anemia, diarrhea, vomiting, weight loss, and sometimes death if not treated properly. [dermatologyadvisor.com]
Skin
- Erythema
(definite erythema with some inflammation), 4=very severe (definite erythema with severe inflammation) 2. [clinicaltrialsregister.eu]
Erythema not prominent. Most cases of familial PRP. [medscape.com]
All rights reserved. seborrheic dermatitis exam An idiopathic spongiotic dermatitis characterised by greasy or dry white scales, variably accompanied by erythema. [medical-dictionary.thefreedictionary.com]
Dermoscopic examination (performed with DermLite DL3 x10; 3Gen, San Juan Capistrano, CA, USA) revealed diffuse white scales and compact white keratotic material adhering to tufts of hair (asbestos-like scaling) without erythema (Figure 1b); interestingly [dpcj.org]
Clinically, all cases were associated with pruritus and erythema. Only one case showed scarring alopecia (1/7, 14.2%). Direct mycological examination and culture of scales and hair were negative. [scielo.br]
- Skin Disease
Intervention Parents completed a questionnaire recording demographic information and personal and family history of skin problems and related diseases. [jamanetwork.com]
Is it strain variability that accounts for skin disease and scalp involvement separately? Or, does local immunity play a role in the disease predisposition? Many questions are yet to be answered. [ijtrichology.com]
"Skin diseases associated with Malassezia species". J. Am. Acad. Dermatol. 51 (5): 785–98. doi:10.1016/j.jaad.2003.12.034. [en.wikipedia.org]
Skin diseases associated with Malassezia species. J Am Acad Dermatol. 2004;51:785-798. Rasika M, Parameshwari S, Sivagurunathan P, Uma C, Bhuvaneswari M. Antifungal activity of Amla extracts against dandruff causing pathogens (Malassezia sp.). [pubmed.ncbi.nlm.nih.gov]
Keywords: Dandruff, cosmetic problem, scalp disease, shampoos How to cite this article: Ranganathan S, Mukhopadhyay T. Dandruff: The most commercially exploited skin disease. [e-ijd.org]
- Papule
Other areas The chest - there are usually papules with greasy scales; however, less commonly there are macules and papules similar to extensive pityriasis rosea. The sternum and upper back (between the scapulae) - may have fine scaling plaques. [patient.info]
Pityriasis rubra pilaris (PRP) is a red scaly eruption characterized by the association of palmoplantar keratoderma, follicular plugging, and erythematous perifollicular papules which may progress to plaques or erythroderma (White, 2003). [medscape.com]
Pityriasis Rubra Pilaris (PRP) a chronic papulo-squamous disease (a skin eruption composed of papules and loose scaly lesions), characterised by a reddish/orange patchy rash on the scalp, chest or face, which may extend to other regions elbows and knees [hairscientists.org]
- Urticaria
Adverse effects include headache, gastrointestinal disturbance and, less commonly, urticaria, diarrhoea and photosensitivity. The drug should be avoided during pregnancy and in patients with liver disease. [nps.org.au]
Neurologic
- Confusion
Confusion with ringworm may exist. Diagnosis is assisted by skin biopsy or blood test. Recurrence is rare. The condition is not considered contagious or symptomatic of internal disease. [hairscientists.org]
For example, tinea corporis can be confused with eczema, tinea capitis can be confused with alopecia areata, and onychomycosis can be confused with dystrophic toe-nails from repeated low-level trauma. [aafp.org]
Workup
Further workup depending on the patient setting may include calcium levels, ACE levels and chest X-ray to evaluate for/rule out sarcoidosis; zinc levels for acrodermatitis enteropathica, appropriate cancer screening for erythrodermic variants and CBC. [dermatologyadvisor.com]
Microbiology
- Malassezia Furfur
Some loss of surface skin cells is normal, but excessive scaliness may be due to infection with the fungus Malassezia furfur that causes PITYRIASIS VERSICOLOR. [medical-dictionary.thefreedictionary.com]
Excessive shedding of dry scaly material from the scalp in humans. [ ] A seborrheic dermatitis that involves fungal infection of the scalp of recently born babies caused by Malassezia furfur. It is occasionally linked to immune disorders. [ebi.ac.uk]
furfur Management Investigations not usually necessary Yellow-green fluorescence seen under Wood's light Treatment with topical antifungals, especially imidazoles, usually adequate, although more severe cases may require oral antifungal (itraconazole [gponline.com]
As the causative yeast Malassezia furfur is part of the normal skin flora, prophylactic treatment is often necessary to avoid recurrences. [nps.org.au]
Bacterial presence was in turn influenced by water and sebum amount.[18] Older literature cites the fungus Malassezia furfur (previously known as Pityrosporum ovale) as the cause of dandruff. [en.wikipedia.org]
- Staphylococcus Aureus
Staphylococcus aureus are probably more second colonization than primary pyogenic infection. [therapeutique-dermatologique.org]
Treatment
AIMS The objective of this study is to enhance the understanding of its wide causes, pathophysiology, current treatment, and future approach. [unboundmedicine.com]
This active ingredient has well established antifungal properties, demonstrated by a number of years' use in a treatment for other fungal skin infections, that make it suitable for the treatment of pityriasis capitis and sebhorrhoeic dermatitis. [hra.nhs.uk]
Patients with severe and widespread or treatment resistant forms may warrant systemic therapy. Seborrheic dermatitis responds fairly rapidly with treatment, improving within days to one to two weeks with therapy with daily treatment. [dermatologyadvisor.com]
At mfine, you will receive a holistic treatment plan for optimum health. [mfine.co]
Aims The objective of this study is to enhance the understanding of its wide causes, pathophysiology, current treatment, and future approach. [onlinelibrary.wiley.com]
Prognosis
Prognosis The condition usually responds well to treatment. It often relapses, so maintenance or intermittent treatment may be required. [patient.info]
Outlook (Prognosis) It may be hard to get rid of ringworm. Also, the problem may come back after it is treated. In many cases, it gets better on its own after puberty. [mountsinai.org]
It is seen most commonly in children aged between 5 and 10 years. [6] Mean age of onset is in patients aged 6.9-8.1 years. [7] Prognosis Tinea capitis carries a positive prognosis, with the vast majority of those treated obtaining resolution of the infection [emedicine.medscape.com]
Prognosis; Seborrhoeic dermatitis is a chronic condition which can be managed with treatment. Cure is not a word to use although the condition may remain inactive for long periods. [hairscientists.org]
Patient Management Seborrheic dermatitis is a self-limited condition with a good prognosis in infants compared with the chronic, relapsing form commonly seen in adults. [dermatologyadvisor.com]
Etiology
"Malassezia and seborrheic dermatitis: etiology and treatment". Journal of Cosmetic Science. 57 (2): 181–2. PMID 16758556. ^ Gemmer CM, DeAngelis YM, Theelen B, Boekhout T, Dawson Jr TL (2002). [en.wikipedia.org]
When we discuss about dandruff and its etiology, we should highlight all the known/reported causes of dandruff. The triggering factors are both microbial and non-microbial. [ijtrichology.com]
The role of sebaceous gland activity and scalp microfloral metabolism in the etiology of seborrheic dermatitis and dandruff. Ro BI, Dawson TL. Ro BI, et al. J Investig Dermatol Symp Proc. 2005 Dec;10(3):194-7. doi: 10.1111/j.1087-0024.2005.10104.x. [pubmed.ncbi.nlm.nih.gov]
Etiology and management of seborrheic dermatitis. Dermatology 2004;208:89-93. 15. Donnarumma G, Paoletti I, Buommino E, Orlando M, Tufano MA, Baroni A. [e-ijd.org]
Etiology Pathophysiology The etiology of seborrheic dermatitis remains to be elucidated. [dermatologyadvisor.com]
Epidemiology
Feldmeier H: Pediculosis capitis: new insights into epidemiology, diagnosis and treatment. Eur J Clin Microbiol Infect Dis 2012;31:2105-2110. [karger.com]
We aim to analyze the epidemiological and clinical profiles of patients with pityriasis amiantacea to better understand treatment responses. [scielo.br]
Epidemiology[1, 2] Globally, seborrhoeic dermatitis occurs in 1-5% of the general population. [patient.info]
Epidemiology Frequency United States Occurrence of the disease is no longer registered by public health agencies; therefore, true incidence is unknown. [emedicine.medscape.com]
[…] its effectiveness in treating seborrheic dermatitis as well.[5] Ciclopirox is widely used as an anti-dandruff agent in most preparations.[23] Coal tar[edit] Coal tar causes the skin to shed dead cells from the top layer and slows skin cell growth.[24] Epidemiology [en.wikipedia.org]
Pathophysiology
"Pityriasis Capitis: Causes, Pathophysiology, Current Modalities, and Future Approach." Journal of Cosmetic Dermatology, 2020. Sheth U, Dande P. Pityriasis capitis: Causes, pathophysiology, current modalities, and future approach. [unboundmedicine.com]
Pierard2007 A comprehensive pathophysiology of dandruff and seborrheic dermatitis - towards a more precise definition of scalp health. J. R. Schwartz, A. Messenger, … M. K. [semanticscholar.org]
Aims: The objective of this study is to enhance the understanding of its wide causes, pathophysiology, current treatment, and future approach. [pubmed.ncbi.nlm.nih.gov]
Aims The objective of this study is to enhance the understanding of its wide causes, pathophysiology, current treatment, and future approach. [onlinelibrary.wiley.com]
Prevention
If you tend to have an oily scalp, daily shampooing may help prevent dandruff. Gently massage your scalp to loosen flakes. Rinse thoroughly.Limit hair styling products. [beautifulmindhealthcare.com]
Treatment and Prevention Dandruff can often be a chronic condition, but it can be controlled with the proper treatment. First, try shampooing with a non-medicated shampoo, massaging the scalp firmly, and then rinsing well. [medbroadcast.com]
Many parents had been sufficiently concerned to seek advice and use products in an attempt to either treat the condition or prevent it from recurring. [jamanetwork.com]
Your skin secretions, sweat and sebum, usually form a protective layer that prevents bacteria from multiplying on your scalp. [philipkingsley.co.uk]
This enables targeted therapy against the specific disease and prevents long term complications such as permanently bald areas. [dermnetnz.org]