Seborrhoeic dermatitis literally means inflammation of the oil-forming glands in the skin, particularly in hairy parts of the body such as the scalp, chest and groin, but also affecting the forehead, cheeks and nose. It is a very common problem in people with symptomatic HIV infection.

Its cause is unclear, but may be related to a fungal infection. The Malassezia species of yeasts have been implicated in several skin conditions including seborrhoeic dermatitis.

Symptoms and diagnosis

The symptoms are usually faint reddish patches on the skin that are sometimes swollen. The surface may be covered with greasy-looking yellow scales.

It can usually be diagnosed by a physical examination, but may sometimes be confused with other skin problems such as psoriasis. If necessary, laboratory examination can reveal distinctive features that make a definitive diagnosis of seborrhoeic dermatitis possible.

Treatment

Seborrhoeic dermatitis often responds to treatment with a steroid ointment. Scalp problems can be relieved with coal tar or anti-dandruff shampoos or an anti-fungal shampoo. In severe cases treatment with creams that combine steroids and anti-fungals such as Canesten HC, Daktacort or Nystan HC, anti-fungal tablets such as ketoconazole, or ultra-violet light therapy, may be needed.

Test tube research indicates that tea tree oil may also be effective against seborrhoeic dermatitis, but it is not known how this would translate into dosage of the essential oil (Hammer 2000).

References

Cockerell CJ. Seborrheic dermatitis-like and atopic dermatitis-like eruptions in HIV-infected patients. Clin Dermatol 9: 49-51, 1991.

Froschl M et al. Seborrheic dermatitis and atopic eczema in human immunodeficiency virus infection. Semin Dermatol 9: 230-232, 1990.

Hammer KA et al. In vitro activities of ketoconazole, ecoazole, Miconazole, and Melaleuca alternifolia (tea tree) oil against Malassezia species. Antimicrob Agents Chemother 44: 467-469, 2000.

Marino CT et al. Seborrheic dermatitis in acquired immunodeficiency syndrome. Cutis 48: 217-218, 1991.