SEBORRHEIC DERMATITIS

• Seborrheic dermatitis(SD) is a chronic inflammatory skin condition that affects areas with high sebaceous activity. The condition is characterized by intermittent flares with intervening asymptomatic periods. The patient may exhibit either an erythematous, patchy scaling or greasy yellow crusts, both of which could be associated with burning or itching
• Seborrheic dermatitis has two age peaks, one in infancy within the first three months of life and the second around the second to the third decade of life. Men are affected more often than women in all age groups

• Various genetic factors, hormonal factors, and increased colonization of Malassezia may cause a role in the causation and perpetuation
• Predisposing factors: Parkinson’s disease, Immunodeficiency, Oily skin (seborrhoea), Androgenetic alopecia, Family history of seborrheic dermatitis, psoriasis
• Psychological stress, fatigue, sleep deprivation 

• Chronic course with episodic active phases (associated burning and itching) alternating with inactive asymptomatic periods
• Infants: Frontal and parietal scalp regions are covered with an oily looking, thick, often fissured crust – crusta lacteal (milk crust, or cradle cap), face and diaper areas are often involved
• Adults: Erythema and greasy scale on the scalp (with often pruritus), paranasal areas, eyebrows, nasolabial folds, central chest, and intertriginous folds ( Seborrheic areas of the body). Rarely generalized lesions may occur. Dandruff is the earliest manifestation of Seborrheic dermatitis 
• Corona seborrheica: Seborrheic dermatitis on the scalp extends beyond the frontal hairline onto the forehead

Differential Diagnosis 

• HIV: patients with HIV tend to have extensive or severe SD
• Scalp Psoriasis: Lesions are well defined, palpably thickened, brighter pink in colour with silvery scales 
• Infective dermatitis complicating pediculosis may mimic SD
• Truncal SD should be differentiated from pityriasis rosea, tinea versicolor
• Follicular SD should be differentiated from Dariers’s disease

• Primarily a clinical diagnosis

Internal medicines

• Patola katurohinyadi kashaya
• Panchatiktaka kashaya
• Vilwadi gutika
• Kaisora guggulu
• Aragwadharishta

Procedures

• Ayyapala kera – ext application
• Dhurdoorapatradi taila – ext application
• Aragwadhadi choorna+ Takra lepa
• Eladi kera – paka with small onion – ext application
• Triphala kashaya + Tankana - kshalana