Seboreyny dermatitis – the skin disease connected with increase in allocation and change of quality of skin fat, and which is followed by a skin inflammation. It is shown by emergence of sites of the grease, brilliant, shining face skin, the head, a back, a breast, a skin thickening, grease hair and dandruff, inflammatory sites erity on skin, a slight itch. Seboreyny dermatitis promotes development of pustulous diseases, vulgar eels, mental and physical discomfort of the patient. Therapy of seboreyny dermatitis includes a hypoallergenic diet, antimikotichesky treatment, physiotherapeutic procedures (cryomassage, a darsonvalization).
Seboreyny dermatitis – a chronic inflammatory disease of skin of papulo-skvamozny character. The drozhzhepodobny lipophilic mushroom of Pityrosporum ovale, three times its name Malassezia, by name the scientist who proved the fungal reason of seborrhea and seboreyny dermatitis is the reason of seboreyny dermatitis.
Reasons of seboreyny dermatitis
The leading role of P. ovale in development of seboreyny dermatitis was proved in 1874 that is confirmed today with clinical and laboratory trials in the field of a trikhologiya. Lipophilic drozhzhepodobny mushrooms are facultative microflora more than at 90% of the population. Though today the hypothesis that existence of P.ovale is the hidden carriage, but not manifestation of norm is reasonable as patients with a lipophilic fungus have these or those seboreyny manifestations and problems with skin. However not always the carriage leads to formation of seboreyny dermatitis.
At the normal state of the general and local immunity mushrooms are in a sporous state, and only in the presence of some factors their activization is noted. Using a secret of sebaceous glands for the growth and development, fungal microflora also causes the phenomena of seboreyny dermatitis. Most often seboreyny dermatitis is diagnosed on a hairy part of the head because of abundance of hair follicles and sebaceous glands. Though displays of seboreyny dermatitis can be noted everywhere where there are sebaceous glands. The fungus of Malassezia furfur strikes generally hairy part of the head, and Pityrosporum orbicuiare – smooth skin though both of them are subspecies of P. ovale.
Under adverse conditions the organism loses control over growth of pitirosporovy mushrooms, barrier function of skin is broken, the composition of skin fat changes and its office increases, as becomes the trigger in development of seboreyny dermatitis. At clinically healthy people fungal flora makes about 30% of all microorganisms living on head skin. At seborrhea their quantity reaches 70%, and at seboreyny dermatitis reaches 90%. In the defeat centers allocate with seboreyny dermatitis different types of lipophilic mushrooms though the leading role in its development after all in sort P.ovale mushrooms.
Hyper activation of fungal microflora is promoted by violations of nervous system, hormonal and immune violations. Often seboreyny dermatitis is debuted after severe emotional stresses or after considerable physical activities. It is noted that at change of a climatic zone seboreyny dermatitis are diagnosed for people who had various seboreyny manifestations more often. At the same time incidence increases as at change from cold climate on warm, and on the contrary. Accommodation in the conditions of sharply continental climate with other risk factors sharply increases probability of development of seboreyny dermatitis.
The neurogenetic nature of seboreyny dermatitis is caused by the fact that at the patients having in the anamnesis of pathology of spinal and cranial nerves, paralyzes and paresis, the incidence is higher. For example, Parkinson's disease is always accompanied by the seborrhea or seboreyny dermatitis having an identical etiology and pathogenesis.
Genetically predisposed states at which the hormonal background is changed are one of risk factors. As it is noted that incidence of seboreyny dermatitis is higher in those families whose relatives had seborrhea, eczema or seboreyny dermatitis.
Displays of seboreyny dermatitis at adults
Seboreyny dermatitis proceeds as dermatitis with the pronounced phenomena of inflammations in the form of papulo-skvamozny rashes. The centers of an inflammation are accurately outlined, red color and are covered with a layer of fat scales which consist of slushchenny epidermis. At seboreyny dermatitis of a spot tend to the peripheral growth and merge. Usually seboreyny dermatitis a hairy part of the head, a face and the top part of a trunk, that is skin rich with sebaceous glands is surprised. At immunodeficiencies seboreyny dermatitis affects axillary hollows and inguinal folds.
About 3-5% of adult population from 20 to 40 years have seboreyny dermatitis though the dandruff and seborrhea preceding it meets considerably more often. Very seldom the disease develops till the pubertatny period that is connected with features of a salootdeleniye in various age groups.
At seboreyny dermatitis there is dandruff in the beginning, and therefore the dandruff which is not giving in to therapy is one of signs of a hyperactivity of pitirosporovy mushrooms. Further perifollikulyarny reddening and formation of seboreyny plaques which because of peripheral growth occupy the most part of a hairy part of the head over time is noted. Seboreyny dermatitis is followed by a hair loss which normal quantity is restored only during remission.
The centers of a peeling are often localized behind ears that leads to emergence of the cracks inclined to bleeding covered with crusts. Developing of persistiruyushchy external otitis can be the only display of seboreyny dermatitis or be combined with other seboreyny damages of skin. Because of an excessive peeling head skin is densely covered with the scales which are stuck together by skin fat. During their removal the bright pink inflamed surface which is quite often painful is bared. The severe itch by which seboreyny dermatitis is followed promotes maceration and accession of a secondary infection. Scales exfoliate as it is single, and large layers, and therefore otsloyenny epidermis can be observed in the mass of hair and on clothes. People, with dark hair color have them more noticeable.
Seboreyny dermatitis of face skin is followed by rashes in a zone of eyebrows, in the field of nasolabial folds and is usually combined with displays of seboreyny dermatitis of a hairy part of the head. If skin is involved a century in process, then seboreyny dermatitis proceeds as blefarit with stratification of numerous white scales and yellowish crusts.
Unlike dandruff seboreyny dermatitis is not a problem only of esthetic character as quite often it passes into seboreyny eczema, generalizutsya with the subsequent development of an eritrodermiya and is complicated by a piodermiya.
Displays of seboreyny dermatitis at children
Seboreyny dermatitis is diagnosed for children up to 6 months and by the time of the complete or partial cessation of feeding by breast milk its symptomatology gradually dies away. At adult age developing of seboreyny dermatitis as it is not connected with its emergence in infancy. The increased content of hormones in mother's milk is the main reason for seboreyny dermatitis of babies. Clinically it is shown by red rashes with accurate outlines, diffusion defeat of natural folds and cortical scales on head skin. Eritematozno-vezikulyarnye rashes are shelled, but their emergence is not followed by an itch therefore the dream of the child does not suffer. And, in spite of the fact that are subject to risk of developing of seboreyny dermatitis as the children who are on breastfeeding - when are available for mother hormonal violations; and the children receiving artificial feeding, the forecast of treatment favorable. At correction of food recovery occurs in several months. In that case when rashes do not pass, it is necessary to differentiate seboreyny dermatitis with atopic. Important differences between which that atopic dermatitis is followed by an itch and it is inclined to a frequent recurrence that at seboreyny dermatitis is not observed.
Diagnosis of seboreyny dermatitis
The clinical manifestations and data of poll of the patient received during consultation of the trichologist are the main criteria for diagnosis. At Dermoscopy of head skin her irritation, dandruff, inflammatory reaction, excess of skin fat and the phenomenon of a giperkeratoz comes to light. Researches of a hormonal background and blood tests, the spectral analysis of hair help to specify the diagnosis and to reveal states which served as the cause of seboreyny dermatitis. At children seboreyny dermatitis needs to be differentiated with atopic, at adults to exclude other fungal diseases.
Treatment of seboreyny dermatitis
Treatment of seboreyny dermatitis has to be complex, directed both to elimination of clinical manifestations, and to correction of diseases which served as the reason of its emergence. First of all it is necessary to normalize a diet, the hypoallergenic diet is recommended. It is necessary to include products in a diet vitamin-rich groups B, A, C, selenium and zinc. However it is necessary to consider that and the surplus of minerals in an organism can become the reason of other complications.
Locally resort to etiotropny therapy of seboreyny dermatitis, using the antifungal medicines containing and . However because of a thick layer of scales active agent not fully influences mushrooms therefore in the presence of scales apply applications with vegetable oils and keratolitichesky ointments then begin antifungal therapy. The entire period of treatment of seboreyny dermatitis it is necessary to use shampoos for treatment of hair which part zinc, the keratolitichesky components and components which are eliminating excess of skin fat, but not overdrying skin is.
At initial stages of seboreyny dermatitis experts try to avoid purpose of the external means containing as prolonged use of these medicines causes impotence in boys, decrease a libido and erectile dysfunction - in adult men.
From physiotherapy cryomassage and influence of high-frequency currents across Darsonval is shown. At cryomassage the area of head skin is cooled that first of all removes symptomatology of a skin itch and calms the inflamed skin, efficiency of cryomassage consists even in improvement of microcirculation and in strengthening of vessels of head skin. It increases local immunity and improves a condition of skin at patients with seboreyny dermatitis. At a darsonvalization there is a dehumidification of skin at the expense of what scales separate quicker, and fresh epidermis becomes steadier to mechanical damage. As a result of a darsonvalization life cycle of cages is normalized and eliminated their premature otsloyka. In addition high-frequency currents have calming effect on nervous system that contributes to normalization of level of adrenaline and testosterone in blood as at their high concentration activity of sebaceous glands is stirred up.
At inefficiency of anti-fungal medicines gormonosoderzhashchy ointments are appointed, and at a complication piodermiya – antibacterial means. It is necessary to consider that use of these medicines without indications is not admissible as antibiotics, influencing all microflora, can cause the strengthened colonization of pitirosporovy mushrooms, and hormonal medicines at prolonged use conduct to an epidermis atrophy.
As incidence of seboreyny dermatitis constantly grows and in the absence of adequate treatment leads to baldness, it is necessary to pay special attention to a healthy lifestyle and timely correction of dandruff which leads to the seborrhea which is the beginning of seboreyny dermatitis.