Seborrheic Dermatitis

Etiology

Background

Although the name implies that seborrheic may be eczematous in nature, the term dermatitis here is used loosely, as seborrheic dermatitis often displays overlapping features of eczema and psoriasis.
Very common, with US prevalence of 5.86%, global prevalence of 4.38%. 38958996

Treatment

Isotretinoin

Isotretinoin is an effective therapy for seborrheic dermatitis

Isotretinoin for the management of moderate-to-severe seborrheic dermatitis: A systematic review. J Am Acad Dermatol. 2023. PMID: 37453557.

MY SUMMARY: Systematic review of isotretinoin for seb derm. 7 studies including 229 patients deemed relevant. Average dose was ~10mg/d for 4 months. Overall, performed better than itraconazole, antifungal shampoo, and SA soap. 45% had complete/excellent clearance, and only 4% reported no benefit. Relapse rate at 3 months was ~11%. Those with truncal SD seem to get most benefit, followed by face, then scalp.

Roflumilast (Zoryve)

Roflumilast 0.3% foam

~50% of patients will achieve complete clearance by week 8. 43% of patients will be clear or almost clear by week 2. 38253129
- Patients 9 and up with seborrheic dermatitis (not confined to the scalp). At 8 weeks, 79.5% of patients experienced a result of clear or almost clear. Attributable effect size was 21.5% (58% of vehicle treated patients also achieved clear or almost clear results). The percentage of patients achieve complete almost clear results was pretty much equivalent in each group, but patients using roflumilast achieved clear results ~50% of the time, compared to ~28% of vehicle treated patients.
- Side effects were minimal, primarily application site reactions, and were similar between treatment and vehicle groups. 5 patients in the treatment group reported nausea, none in the vehicle group.