It usually starts from the head, and when the symptoms worsen, it will develop to other parts, such as the face, behind the ears and upper chest. It is flaky gray-white chaff scales, slightly red at the base and slightly itchy. In severe cases, it shows greasy scaly map spots, which may be accompanied by exudation and thick scab. Seborrheic dermatitis is more common in adults and newborns.
The cause of seborrheic dermatitis is still unknown. Some people think it is related to heredity, but it has not been confirmed. This disease is secondary inflammation of the skin caused by sebum overflow. Mental factors, eating habits, vitamin B deficiency and alcoholism may have some influence on the occurrence and development of this disease.
Treatment mainly lies in keeping skin clean, limiting fat diet and using drugs.
prescription
1. Limit fatty foods and sweets, such as fat, cream cakes and chocolate, and eat more vegetables and fruits.
2. Wash your face with warm water with a small amount of sulfur soap or boric acid soap every night. Remove greasy face and clean skin.
3. It takes patience to take medicine according to the doctor's advice.
Seborrheic dermatitis [Overview] Seborrheic dermatitis is a chronic inflammatory skin disease that occurs in seborrhea. Typical skin lesions are dark yellow-red papules or plaques with clear edges, greasy scales or scabs on the surface, accompanied by itching to varying degrees. The cause is still unknown. At present, some researchers believe that the disease is caused by the imbalance of normal flora on the skin surface and the increase of pityrosporum ovale growth on the basis of seborrhea.
[Symptoms] 1. Typical skin lesions are dark yellow-red spots, patches or maculopapules with clear edges, and the surface is covered with greasy scales or scabs. The clinical manifestations are slightly different due to different lesion sites. 2. The rash occurs in scalp, eyebrows, eyelids, nose and sides, behind ears, neck, chest and upper back, scapula, armpit, groin, umbilical fossa and other sebaceous glands-rich parts; 3. Self-conscious symptoms are itching in different degrees; 4. Infantile seborrheic dermatitis mostly occurs after birth 1 month, and the lesions are mostly on scalp, forehead, eyebrows and cheeks, which are overflowing red patches with yellow scabs.
[Diagnostic basis] 1. Common in adults and newborns, typical lesions are dark yellow and red patches or maculopapules with clear edges; Covered with greasy scales or scabs, symmetrically distributed; 2. Skin lesions occur in areas rich in sebaceous glands, such as head, face and folds. 3. The course of disease is chronic, accompanied by different degrees of itching.
[therapeutic principle]
First, systemic therapy: 1. Vitamin B2, B6 and vitamin B complex, etc. 2. When itching is serious, sedative and antipruritic agents can be given; 3. When the inflammation is obvious or the scope of inflammation is large, corticosteroids and antibiotics can be given for a short time. Second, local treatment: the principle of treatment is to remove fat, diminish inflammation, sterilize and relieve itching.
[Efficacy evaluation] 1. Cure: the symptoms disappeared and the rash subsided; 2. Improvement: the symptoms are relieved and most of the rash subsides; 3. Unresolved: Symptoms and rashes have not improved.
[Expert tip] This disease is generally not difficult to diagnose, but we should be alert to differentiate it from erythema pemphigus, so as not to delay the treatment opportunity and cause serious consequences. During the treatment, we should also pay attention to the law of life, get enough sleep, limit the diet of fat and polysaccharide, avoid drinking alcohol and spicy food, wash our hair with less hot water and soap, and avoid various mechanical stimuli such as combing our hair.
Pathological overview of alias of seborrheic dermatitis
This disease is a chronic inflammation based on sebum overflow. The main damage is bright red or yellow red spots covered with greasy scales or scabs. It usually occurs in the scalp and can also spread to other sebaceous glands. Epidemiological characteristics, pathogenesis and treatment
1, systemic therapy: take B vitamins, such as B2 and B6. Sedatives and antipruritics can be used when itching is severe. Severe cases can be treated with corticosteroids and antibiotics. Others can be intravenously injected with vitamin C and sodium thiosulfate. Traditional Chinese medicine treatment is mainly to dispel wind, moisten dryness and clear heat. 2. Local treatment: mainly dissolving fat, exfoliating, diminishing inflammation and relieving itching, and choosing different dosage forms according to different parts and different lesions. In recent years, ketoconazole preparations have been widely used, and its therapeutic mechanism is to inhibit the reproduction of Pityrosporum ovale, reduce the level of testosterone, and affect the activities of keratinocytes and sebaceous glands. prevent
1, limit the fat and polysaccharide diet and eat more vegetables. 2. Wash your hair with less hot soap. 3, avoid all kinds of mechanical stimulation, such as combing your hair. clinical picture
Seborrheic dermatitis mainly occurs in young people and adult patients with exuberant sebaceous glands, especially in areas rich in sebaceous glands. Lesions are often brown or yellow-red patches with clear boundaries and greasy scales or scabs on them. The clinical manifestations also vary with the location and severity of the injury: 1. Scalp: at first, it was a large gray-white chaff-like or greasy scaly patch, and then it gradually expanded and merged into a well-defined large patch. In severe cases, the whole scalp is covered with greasy scabs and hair loss. 2, face, ears, behind the ears and neck: often spread from the scalp, yellow-red or greasy scaly macula. 3, beard: There are two types, one is that the hair follicle mouth is slightly red and swollen, and the inflammation is accompanied by a small light brown scab, that is, "beard sore", which is stubborn and refractory. The other is disseminated red greasy scales, and pustules form deeply, involving the whole hair follicle. 4. Trunk: Small reddish-brown hair follicle papules with greasy scales at first, and then gradually become annular patches with fine chaff scales in the center, dark red papules and large greasy scales at the edge, mostly between the chest and shoulder blades. 5. Wrinkles: Obese middle-aged people are more common, and skin lesions exist in the form of disseminated frictional erythema with clear boundaries and greasy scales on it. 6. Limbs: The injury is eczema plaque. 7. Baby: It is characterized by erythema and scales, round or oval, with clear boundaries, and usually recovers within 3 weeks to 2 months. diagnose
It occurs on the basis of sebum overflow, often spreading downward from the head, and often occurs in parts with more sebum overflow. There are greasy scaly yellow and red spots with clear boundaries and symmetrical distribution, which are self-itchy, chronic and easy to recur. differential diagnosis
complication
The cause of disease
The etiology is unknown, which may be related to immune, genetic, hormonal, neurological and environmental factors. It may be caused by excessive sebum overflow, secondary infection of fungi (Pityrosporum ovale) and bacteria (Propionibacterium acnes) and secondary allergy to the bacteria. Autoimmunity plays a role in the occurrence of secondary eczema and disseminated seborrheic dermatitis One of the most common skin symptoms of AIDS is this disease.
Important pathological changes
Focal sponge edema in the funnel of hair follicle,
B Scales and scabs can be seen at the "lip edge" of the hair follicle mouth, and the epidermis on both sides of the hair follicle mouth is not fully keratinized, including uniform red serosity and neutrophils.
C hyperkeratosis and hypokeratosis constitute hair follicle corner plugs.
General pathological changes
Acute stage: mild focal spongiform edema, infiltration of lymphocytes and histiocytes around superficial blood vessels, accompanied by a little neutrophil, obvious expansion of superficial dermal blood vessels, dermal papilla edema,
B subacute stage: mild spongiform edema, psoriasis-like hyperplasia, sparse lymphocyte and histiocyte infiltration around superficial dermis blood vessels, obvious telangiectasia, hair follicle angular plug,
C chronic stage: hair follicle angular plug, with dyskeratosis, psoriasis-like hyperplasia of epidermis, sparse lymphocyte infiltration around superficial blood vessels, obvious expansion of small veins and capillaries in superficial blood vessels.
Pathological differential diagnosis
Psoriasis: generally, there is no sponge edema, and there is no scale scab at the "lip edge" of hair follicle mouth.
Dermatomycosis: There are hyphae and spores in the stratum corneum, which can be clearly displayed by PAS staining.
Pustus: Gram staining showed positive cocci in the stratum corneum.
clinical features
A mostly occurs on the basis of sebum overflow,
B is common in seborrheic parts such as head, face and back, and can spread to the whole body in severe cases.
Skin lesions are erythema with clear boundaries, with thin scales and scabs.
D feels itchy,
Infantile generalized seborrheic dermatitis is a self-limiting disease, called Lena's disease.
Clinical differential diagnosis
psoriasis
Pityriasis rosea
eczema
What's with the wind blowing on your face?
Facial wind, equivalent to seborrheic dermatitis of head and face in western medicine, is a disease characterized by edema, itching and peeling, exudation and scab of head and face. There are also names such as "face wind" and "face wind poison" in Chinese medicine. In the Qing Dynasty, it was also recorded in the Golden Mirror of Medical Sect: Essentials of Surgical Psychology: "This syndrome was born on the face, with edema, itching like insects, dry skin and sometimes white spots at first. After the second time, it was extremely itchy, scratching, damp and hot with yellow water, wind and blood, painful and embarrassing. " Due to the different location and severity of the injury, the clinical manifestations of this disease are also different:
(1) At the beginning of the scalp, small pieces of white dander, such as chaff or greasy scaly patches, can be seen in the hair. Later, the fusion gradually expanded, even involving the forehead, and papules, exudates and scabs were visible. In severe cases, the whole head is covered with thick scabs and the hair falls off.
(2) The face, ears, behind the ears and neck often spread from the scalp, especially the forehead, eyes, eyelids and nasolabial groove of the face. At first, the affected area was red, and papules the size of millet appeared one after another. After a long time, the color turns red and yellow, covered with greasy and thick scabs, such as cream, or the body fluid is yellow and sticky and itchy, and the eyebrows often fall off occasionally due to scratching, and the nasolabial groove and behind the ears may be chapped.
(3) There are two kinds of beards. One is that the skin lesions are red, and there may be a light brown scab, which looks like a beard and is often called a beard. The other is generalized red with more white debris, pustules and scars.
This disease is often aggravated by improper diet, alcoholism and mental stress, so it has a long course and is easy to repeat.
What disease should seborrheic dermatitis be differentiated from?
Seborrheic dermatitis occurs on the basis of excessive seborrhea. It often spreads downward from the head and mostly occurs in the parts where sebaceous glands are distributed. Its clinical manifestations are greasy scaly yellow-red spots with clear boundaries and conscious itching. Because it is a common disease, it should be differentiated from other diseases to avoid misdiagnosis:
(1) Psoriasis lesions on the head and face are scattered and flaky, with clear boundaries, thick scales, uneven touch, no hair shedding and short hair bunching. In severe cases, the lesions can be connected into large pieces, extending to the front hairline and invading the forehead for several centimeters. Scraping scales has membrane phenomenon (that is, scraping scales, there is a layer of red shiny membrane below) and bleeding phenomenon (that is, small bleeding spots can appear when scraping the membrane lightly), which is an important feature of psoriasis damage.
(2) Pityriasis rosea mainly occurs in the neck, trunk and proximal limbs, showing an oval macula with a slightly yellow center, slightly convex edges and reddish skin with white pityriasis-like scales. At first, it was a single lesion, called mother spot; The mother spot is getting bigger and bigger, with a diameter of more than 2 ~ 5 cm. Sometimes two or three mother spots appear at the same time. 1 ~ 2 months later, smaller erythema appeared one after another, appearing on the trunk. The long axis of the rash is consistent with the dermatoglyphics. Generally, it can disappear by itself after 4 ~ 6 weeks without recurrence.
(3) The ringworm edge is swollen and narrow. The boundary is clear, there is an annular lesion, the center has healed and spread around. Itching is obvious, and patients often have a history of onychomycosis of hands and feet.
(4) Erythematous pemphigus mainly distributed in the middle face, neck and chest and back. At first, there was symmetrical erythema on the face, covered with scales and scabs, and blisters appeared on the back of neck and chest on the basis of erythema, which formed scab skin after rupture, and Nissl's sign was positive. (that is, when pressure is applied to the top of the blister, it can be seen that the blister fluid penetrates into the surrounding epidermis; Pulling the residual wall of the blister wall leads to further shedding of the surrounding epidermis; More importantly, skin with normal appearance is also broken when rubbed.
(5) Drunk dermatitis does not involve the scalp. Eyebrows and nasolabial sulcus are not the most common parts, and most of them have a long history of external use of hormone preparations.
Is Chinese medicine effective in treating facial wind?
Facial wind, that is, seborrheic dermatitis on the head and face, not only affects the appearance, but more importantly, makes patients feel itchy and unbearable, which seriously hinders their daily work and life. How can he restore his former health? Traditional Chinese medicine believes that this disease is mostly caused by wind-heat invasion, long-term stagnation of blood dryness, skin malnutrition or overeating spicy and thick taste, which leads to the steaming of Yangming stomach meridian due to damp heat. Traditional Chinese medicine mostly adopts the methods of cooling blood and expelling wind, eliminating dampness and dredging fu organs, nourishing yin and moistening dryness, and has achieved good results. In addition, if combined with external medicine, you can get twice the result with half the effort.
In addition to the above treatment, the patient's daily life is self-care, such as life rules; Pay attention to diet, limit the intake of lipopolysaccharide food and avoid spicy food; Do not drink alcohol, keep the stool unobstructed; It is also important not to wash with irritating soap.
Dry skin with small bags on the face: seborrheic dermatitis 20065438+0 February15 June 16:20 Sina Life
Q: The skin on my face is getting worse recently, not youth bean. Anyway, it's just some small bags, which are not big, red and itchy, and the skin is very dry. So you look old, like a 30-year-old. What should I do? What should I pay attention to in my diet? Should we eat more fruit?
Dr. Wu answered: The skin is dry, even peeling, and erythema appears. This is a common skin disease called seborrheic dermatitis.
It is caused by abnormal sebum secretion and mycoplasma furfur infection. It often occurs on the face, chest and back. Common in winter and spring, often caused by fatigue, emotional tension or infection.
Because sebum secretion is less, daily facial cleanser should not be too alkaline. Pay attention to diet control, eat less polysaccharide and fat diet, eat more fruit and water, avoid spicy and irritating food, avoid scratching and live a regular life.
Treatment can be external use of vitamin B6 ointment, and short-term use of hormones with small side effects, such as Youdelue and Ailuosheng, once a day for no more than one month. During the onset, skin care products should use oily cream instead of alcohol preparation. It can also be combined with oral vitamin B.
Nursing care of seborrheic dermatitis
Seborrheic dermatitis is an inflammatory skin disease that occurs at the site of seborrhea. It usually starts from the head, and when the symptoms worsen, it will develop to other parts, such as the face, behind the ears and upper chest. It is flaky gray-white chaff scales, slightly red at the base and slightly itchy. In severe cases, it shows greasy scaly map spots, which may be accompanied by exudation and thick scab. Seborrheic dermatitis is more common in adults and newborns.
The cause of seborrheic dermatitis is still unknown. Some people think it is related to heredity, but it has not been confirmed. This disease is secondary inflammation of the skin caused by sebum overflow. Mental factors, eating habits, vitamin B deficiency and alcoholism may have some influence on the occurrence and development of this disease.
Treatment mainly lies in keeping skin clean, limiting fat diet and using drugs.
Nursing points
Limit high-fat foods and sweets, such as fat, cream cakes, chocolates, etc. Eat more fruits and vegetables.
◆ Wash your face with warm water and a small amount of sulfur soap or boric acid soap every night. Remove greasy face and clean skin.
Taking medicine according to the doctor's advice requires patience to be effective.
/sljk/pfk/zyxpy.htm