History and exam

Key diagnostic factors

common

scalp itching

Skin is highly sensitive; itching can be severe. Bleeding may occur if lesions are scratched vigorously.

scalp scaling

Erythematous, circumscribed, scaly patches on scalp.

glabella scaling

Erythema accompanied by greasy scales in the glabella are often present.[Figure caption and citation for the preceding image starts]: Seborrhoeic dermatitis, glabella, with scaling and mild erythemaFrom the collection of Robert A. Schwartz, MD, MPH, FACP, FAAD, FRCP (Edin) [Citation ends].com.bmj.content.model.Caption@37243029

nasolabial fold scaling

Erythema accompanied by greasy scales in the nasolabial folds are often present.[Figure caption and citation for the preceding image starts]: Seborrhoeic dermatitis, nasolabial fold, with mild scaling and mild erythemaFrom the collection of Robert A. Schwartz, MD, MPH, FACP, FAAD, FRCP (Edin) [Citation ends].com.bmj.content.model.Caption@4323e3ab

post-auricular scaling

Erythema accompanied by greasy scales in the postauricular area are often present.

white flakes

Greasy white flakes deposited on clothing and in hair.

erythema

Inflammation of the cutaneous layer causes reddened patches.

Risk factors

strong

HIV/AIDS

An explosive, often generalised, onset of SD may be a marker for HIV infection, regardless of age. It may appear as a central facial rash, similar to that associated with systemic lupus erythematosus. Around 35% of people with early HIV infection have SD, and the prevalence reaches 85% in patients with AIDS.[13]

age <3 months

Cradle cap is common in infancy. Aetiology may be hormonal.

weak

stress

Stress aggravates the occurrence of SD and may induce flares.

parkinsonism

A well-recognised association exists between SD and Parkinson's disease (including neuroleptic drug-induced Parkinson's disease).[12]

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