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ADULT SEBORRHOEIC DERMATITIS/ECZEMA
This is a chronic condition affecting mainly the hair bearing regions of the body. It is found more commonly in men and usually in the young, middle aged or obese. Flexural (fold) involvement is, however, common in the elderly.
There are three main clinical patterns of this condition:-
SCALP & FACE
First noticed as dandruff, it gradually extends from the hairline with a sharp delineation of the patches. It can spread to the eyebrows, ears and sides of the nose (upper lip). It usually presents as itchy red or yellowish red patches. It may occasionally have greasy scaling present.
TRUNK
It is found over the sternum region and between the shoulder blades of the back and presents as a dry, scaly, yellowish rash. More frequently found in men, it is extremely itchy and can be accompanied by follicular papules or pustules. The skin can be greasy in appearance.
The above example shows a red/erythema rash due to secondary infection of the follicular papules.
FLEXURAL (Skin Folds)
Found in the armpits, groin, umbilical region and under the breasts. It may also appear between the thighs. It is a moist, superficial inflammation of two skin surfaces that are in contact, particularly in obese people. It is caused by sweating and constant rubbing of the area.
It can also be aggravated by infection, especially Candida albicans (thrush). In severe cases there is extreme itching, spreading ulceration and the formation of opaque, greasy crusts due to weeping.
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