TEACHING BANGSAL

SEBORRHEIC DERMATITIS
GROUP MEMBERS
1. Nancy Pongsibidang 7. Dwi Purnama Sari
2. Nur Hadia Yunus 8. Fathin Nurqalbi Eka Pu
3. Nuril Ilmi 9. Fahrin Husain
4. Fierna Darmawanti Hanafi 10. Hardiyanti Herman
5. Dian Faradibah 11. Nurmitta Astari
6. Mutmainnah
PATIENTS IDENTITY
Name : Mr. Kahar
Gender : Male
Age : 48 y.o
Marital Status : Marital Status
Religion : Moslem
Address : Luwu
Occupation : Farmer
Registered : 30 June 2014

HISTORY TAKING
Anamnesis : Autoanamnesis
Chief complaint : Itchy on Face
Anamnesis Lanjutan :
Since 2 weeks ago, intermittent, itching occured when the
patient sweats. Complaints with scales on his face. Firstly scales
appeared from the corners of the nose and then widened to the
cheeks, forehead, chin, and behind the ears.
Systematical Anamnesis :
Fever (-),
Cough (-), chest pain (-), nausea (-), vomit (-)
Defecation : normal
Urination : normal




History of similar disease : (+)
9 months ago, given treatment with baby powder for 3 days
and recovered
Family History with the same complaint : ( - )
Treatment history : (-)
Lifestyle : smoking (+), alcohol (+)
Allergic : (-)
Systemic disease : (-)
PRESENT STATUS
General condition : Moderate Illness
Consciousness : Compos mentis
Vital sign :
BP : 150/100 mmHg
Pulse : 84x/minute,reguler
Breathing : 22x/minute
Temperature : 37,0
0
C
Internal State
Head Examination : Icteric (-)
Anemic (+)
Cyanosis (-)
Cor / Pulmo : BJ I/II, Pure, Reguler
Thorax : Vesikuler, Rh (+)/Wh(-)
Abdomen : Within Normal Limit, Peristaltic (+)
Extremities : Within Normal Limit
Dermatology Status
- Location : regio scalp
regio facialis
regio retroaurikuler
Efflorescence : yellowish scale

Additional Examination : KOH (-)

RESUME
A male, 48 y.o counseled to Dermatology Department on
June 30th with complaints of pruritic on his face since 2
weeks ago, intermittent, pruritic occured when the patient
sweated. Complaints with scales on his face. Firstly scales
appeared from the corners of the nose and then widened
to the cheeks, forehead, chin, and behind the ears.


Vital Sign:
BP: 150/100 mmHg HR: 84x/minute, reguler
R: 22x/minute T: 37
0
C
Dermatology Status :
Location : regio scalp, regio facialis,
regio retroaurikuler
Efflorescence : Yellowish Scale

DIAGNOSIS
- Seborrheic Dermatitis


Treatment
- Topical : Mikonazole 2% cream 10mg +
Hidrocortison 2,5% cream 5 gr apply
face (Morning-Afternoon)
MBO talc spread into body
- Sistemic : Cetirizine 10mg 0-0-1

PROGNOSIS
- Bonam



Discussion
Seborrheic Dermatitis
Seborrheic Dermatitis

Chronic papulosquamous condition
Occur on sebum-rich area of scalp, face and trunk
Characterized by periods of exacerbation and remission in
adults.
Epidemiology : all ages, men > women
Patogenesis
The etiology is unclear
But there are associations with Malassezia yeasts, sebum
secretion and composition.
The activation of sebaseous gland stimulate the increasing
production of sebum .
Patofisiologi
Malassezia ecosystem and its interaction with epidermis
Inflammation
Obstruction to the proliferation proccess and epidermis
differentation
Dysfunction of skin


Diagnosis
Efflorescence
Erythematous and oily yellowish scale, clearless borderline
Predilection area: occur on sebum-rich area of scalp, face
and trunk
Differential Diagnosis
Atopic Dermatitis
Psoriasis
Additional Treatment
Fungal culture and skin smear can be
used to rule out tinea capitis
Serrological examination atopic
dermatitis

Seborrheic Dermatitis in Infant
For Scalp Area
- Salicyclic acid 3% in olive oil - Topical anti-fungal in shampoo
- Moisturize with olive oil -Mild baby shampoo
- Hidrocortison lotion or cream 1% -Proper skincare for babies

Intertigo Area
Using dry lotion such as: Zinc oil 0,3- 0,5% or Imidazole

Seborrheic Dermatitis in Adults
SISTEMIC
a. Isotretinoin 0,05 0,10 mg/kgBB daily for few months.
b. Ketoconazole : 200 400 mg/hr for 2 weeks.

TOPICAL
a. Anti fungal
- Ketoconazole (nizoral) 2%2-4 x/days for 2-4 weeks

- Selenium Sulfide twice a week.
- Cyclopirox Shampoo 1% for 4 weeks

b.Corticosteroid
- Clobetazole for 2 weeks = 50 gr/weeks
- Betamethasone 2-4 x/days

c. Keratolitic
- Salicyclic acid used for 12 weeks
- Tar used with shampoo, wait for 5 minutes, and rinse
- Urea 10% in lotion, cream/gel

d. Calsineurin Inhibitor
- Primecrolimus 2x/a day for 2-6 weeks
(not recommended for children less than 2 years )


Prognosis
For babies: self limiting disease
For adults: chronic and recurrence.

Thank you