Dermatitis is a term meaning "inflammation of the skin". Dermatitis is usually used to refer to eczema, which is also known as dermatitis eczema. Seborrheic dermatitis is a common skin inflammation characterized by a red, scaly, itchy rash primarily occurring on the face, scalp, hairline, eyebrows and trunk. The condition often recurs, requiring re-treatment over time. Cases of atopic dermatitis are on the rise among US children.
   Seborrheic dermatitis is a superficial fungal disease of the skin, occurring in areas rich in sebaceous glands. It is thought that an association exists between Malassezia yeasts and seborrheic dermatitis. This may, in part, be due to an abnormal or inflammatory immune response to these yeasts.

Seborrheic dermatitis - Seborrhea dermatitis
Seborrheic dermatitis is a common disorder for which curative treatment is difficult. Seborrheic dermatitis is a common skin disorder that has several treatment options. This condition is a red, scaly, itchy rash most commonly seen on the scalp, sides of the nose, eyebrows, eyelids, skin behind the ears, and middle of the chest. Other areas, such as the navel (belly button), buttocks, skin folds under the arms, axillary regions, breasts, and groin, may also be involved.
   Seborrheic dermatitis is a subacute or chronic disease of the skin, affecting the seborrhea afflicted areas and presenting with erythema and desquamation. The inflammatory reaction towards the fungi Malassezia spp. is considered to have a basic etiologic connection with this disease. Taking into consideration the pathogenesis, treatment of the dermatitis should be directed towards eradication of Malassezia spp., reduction of the skin lipids, and suppression of the inflammatory response. A wide variety of agents presented in different forms -- ointments, shampoos and drugs -- can offer effective treatment alternatives.

Seborrheic dermatitis treatment
Seborrheic dermatitis is a chronic inflammatory disorder affecting areas of the head and trunk where sebaceous glands are most prominent. Lipophilic yeasts of the Malassezia genus, as well as genetic, environmental and general health factors, contribute to this disorder. Scalp seborrhea varies from mild dandruff to dense, diffuse, adherent scale. Facial and trunk seborrhea is characterized by powdery or greasy scale in skin folds and along hair margins. Treatment options include application of selenium sulfide, pyrithione zinc or ketoconazole -containing shampoos, topical ketoconazole cream or terbinafine solution, topical sodium sulfacetamide and topical corticosteroids. Preliminary studies suggest that terbinafine may be effective.
     Barrier Therapeutics, Inc., a pharmaceutical company developing and commercializing products in the field of dermatology, makes Xolegel (ketoconazole, USP) Gel, 2% for the topical treatment of seborrheic dermatitis in immunocompetent adults and children twelve years of age and older. Xolegel, previously referred to by the Company as Sebazole, is a topical formulation of 2.0% ketoconazole, an antifungal agent, in a waterless gel for once-daily application. Xolegel is the first prescription gel formulation of ketoconazole in the U.S.

Fluconazole for Seborrheic Dermatitis
Fluconazole and its place in the treatment of seborrheic dermatitis -- new therapeutic possibilities.
Folia Med (Plovdiv). 2006;48(1):39-45. Department of Dermatology and Sexually Transmitted Diseases, Medical University, Plovdiv, Bulgaria.
The purpose of the present study was to monitor the therapeutic effects of the anti-fungal drug fluconazole in patients with seborrheic dermatitis. We compared two study groups of patients: Group I--27 patients with seborrheic dermatitis stage I, II and III, treated with fluconazole, 50 mg/day for two weeks. As topical therapy we applied clobetasol propionate 0.05% ointment. After the completion of the therapeutic course, 85% of the patients in this group were clinically cured and their symptoms faded away. Fifteen percent of the subjects in this group--mainly stage III seborrheic dermatitis patients, showed partial but significant clinical improvement. The specific fungal test for Malassezia spp. on Dixon agar was negative in 93% of the cases in this group. Group II--eleven patients with similar clinical indexes were treated with fluconazole 50 mg/day only, for the same time period. The therapeutic results in this group were also satisfactory--31.5% of the patients were cured and 68.5% showed clinical improvement. In 74% of the patients the specific test for Malassezia spp. was negative after treatment. Fluconazole treatment in patients with seborrheic dermatitis proves to be effective and safe.

Contact dermatitis
Contact dermatitis accounts for 85-90% of all occupational skin diseases and, as a frequent cause of hand dermatitis.
     A Mayo Clinic team has compiled a top-10 list of the most frequent allergen that causes contact dermatitis. The allergens appear in a wide array of products. Patients underwent skin patch testing for up to 71 allergens. The investigators found that 71 percent of patients had at least one positive reaction and 52 percent had two or more positive results. The 10 most commonly identified allergens were nickel sulfate hexahydrate, balsam of Peru, cobalt chloride, neomycin sulfate, gold sodium thiosulfate, "fragrance mix," thimerosal, formaldehyde, benzalkonium chloride and potassium dichromate.

Atopic dermatitis - Dermatitis Atopica
While pimecrolimus cream can be effective for treating atopic dermatitis (often called eczema), there has been concern about infections because it is an immune suppressing drug -- but that seems to be unfounded. A review of clinical trials that tested pimecrolimus cream in infants with atopic dermatitis indicates that it is not associated with a higher rate of infections, other adverse events or generalized immune suppression.

Combination therapy for atopic dermatitis
Combination therapy with pimecrolimus cream 1%, a topical calcineurin inhibitor, and fluticasone propionate cream 0.05%, a mid-potency topical corticosteroid, does not lead to a synergistic effect in the treatment of atopic dermatitis.

Perioral dermatitis
Perioral dermatitis is a unique skin disorder of childhood. Its exact origin is unknown; it is probably an idiosyncratic response to exogenous factors such as the use of a topical fluorinated corticosteroid or other substances on the face. It is uncommon but not rare. The age of affected children has ranged from 7 months to 13 years, with the median being in the prepubertal period. Boys and girls, blacks and whites are equally affected. Clinical features include the following: (1) absence of systemic symptoms; (2) periorificial distribution (perioral, perinasal, periorbital); (3) skin lesions that consist of flesh colored or erythematous inflammed papules, micronodules, and rare pustules; and (4) variable pruritus. Laboratory tests are negative.

Dermatitis herpetiformis
Dermatitis herpetiformis is characterised by granular IgA precipitates in the papillary dermis. In contrast to other autoimmune blistering diseases, where tissue-deposited and circulating autoantibodies recognise the same target within the skin, in dermatitis herpetiformis a serum IgA reacting with a component of the healthy papillary dermis has not been detected. Recently, the antigenic specificity of pathognomic skin-bound IgA has been clarified: the immune precipitates contain epidermal transglutaminase, an enzyme not previously detected in the papillary region of normal skin. Furthermore, serum IgA in dermatitis herpetiformis has been found to bind epidermal transglutaminase. These findings may relate to the fact, that dermatitis herpetiformis is associated with gluten sensitive enteropathy, coeliac disease, which is characterised by IgA type autoantibodies to a closely related enzyme, tissue transglutaminase.

Nummular dermatitis
This is a chronic inflammation of the skin characterized by coin-shaped, vesicular, crusted, scaling, and usually pruritic lesions. The cause is unknown. Nummular dermatitis is most common in middle-aged patients and is often associated with dry skin, especially during the winter.

Dermatitis Questions
Q. Could tea tree oil be helpful in seborrheic dermatitis?
   A. Perhaps. Tea tree oil cream can be tried first before using pharmaceutical medications.

Q. I'm inquiring on any new meds or creams on seborrheic dermatitis. I've used everything from steroids to israel salts to even the immunomodulators. anything new homeopathic?
   A. This is not an area we have studied in depth. We will update our page on seborrheic dermatitis as we come across more info on natural and alternative treatments for this skin condition.

Q. This is in regards to a condition called perioral dermititis. It's a type of rash that occurs around the mouth (hence the name) but seems to have no identifiable cause, although a number of factors does influence it.  The incidence of perioral dermatitis rash is steadily increasing and researchers have looked to environmental factors to see if there's any correlation in this increase. Originally, I was prescribed a 1% strength topical corticosteroid as treatment (my doctor wasn't sure what it was then). It made a big difference. The problem with this is the perioral dermatitis will return when the corticosteroid is stopped & often much worse. This is what I found. Use of the topical cream needs to be continued indefinitely which is not recommended! I quit using it after a couple of months because of this concern. The rash worsened, as expected, but has not improved even after stopping it for a long time now. I use (with my dentist's approval) a 5:1 mixture of calcium carbonate - sodium bicarbonate to brush my teeth. I highly dislike the feeling that sodium lauryl sulphate causes in my mouth. I don't use face creams. Instead, I use a very tiny amount of shea butter warmed by rubbing between my fingers & spread across my still damp face after washing. My skin is neither dry nor oily - just right really. No use of cinnamon gum or candies either. I wash around my eyes with soap & water. Around my mouth, I use a wet washcloth with a drop of soap only. I wear foundation about twice per week but wash it off immediately when I come home. I've avoided using any since the rash has worsened. I have no allergies, no food, contact, or inhalant sensitivities that I'm aware of - never have had before & never have had any rashes either. My skin
elsewhere is very good. I don't take any hormonal remedies, nothing else unusual or out of the ordinary. My diet is good too. I don't use ready made foods or refined products. My sugar intake is very low. It's just I think this is a topic that would be good to be addressed by Dr. Sahelian since it's more common than many suspect. Most women with it are embarrassed by its appearance & try their best to cover it or take whatever works. Doctors normally treat this with a 3-4 month course of antibiotics (even though no real causative agent has been found) & sometimes, topical
antibiotics as well. Unfortunately, when treatment is finished, many have found that the rash will return in a few months. I prefer not to use antibiotics lightly & haven't needed them for many years as my health otherwise is excellent.
   A. If we come across any natural treatment for perioral dermatitis, we will mention them.

Q. I live in India. I am suffering from seborrheic dermatitis (Sclap) since last 20 years. I have tried everything from shampoos to steroids. Still I am not able to get rid of this condition. I am male , 40 years. I was wondering can you suggest me any new drug I may try.

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