Dermatite seborreica
Open accessAbstract
A dermatite seborreica é uma doença eritêmato-escamativa de caráter crônico-recidivante que acomete entre 1 e 3% da população geral dos Estados Unidos. Possui dois picos de incidência - o primeiro, durante os três primeiros meses de vida, e o segundo, a partir da puberdade, atingindo seu ápice entre os 40 e 60 anos de idade. Os indivíduos HIV positivos têm maior prevalência da doença, que apresenta maior intensidade e tendência à refratariedade ao tratamento. Doenças neurológicas e outras doenças crônicas também estão associadas ao desenvolvimento da dermatite seborreica. Como mecanismo fisiopatogênico, reconhece-se que o fungo Malassezia sp., presente na pele de indivíduos suscetíveis, leve a uma irritação não-imunogênica a partir da produção de metabólitos à base de ácidos graxos insaturados deixados na superfície cutânea. Este artigo faz uma revisão da literatura sobre dermatite seborreica, com ênfase nos aspectos imunogenéticos, formas clínicas e tratamento.
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SD incidence peaks during three age periods: the first three months of life, puberty, and adulthood with an apex at 40 to 60 years of age.
“Its incidence peaks during three age periods - in the first three months of life, during puberty, and in adulthood with an apex at 40 to 60 years of age [1–4].”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [3]
The paper’s Abstract (page unavailable) states that seborrheic dermatitis has two incidence peaks, not three: one in the first three months of life and a second beginning at puberty that reaches its apex at ages 40–60. It does not describe puberty and adulthood as separate peaks. (LLM, conf=0.90)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredIncidence of SD in the general adult population is 1-3%.
“Incidence is 1–3% of the general adult population [3,9].”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [3]
The Abstract reports that seborrheic dermatitis affects 1–3% of the general US population. It does not give that figure specifically for adults or identify it as an incidence rate; it separately describes two age-related peaks in incidence. (LLM, conf=0.88)
Experimental — accuracy not yet measuredSD may be associated with sex hormones such as androgens.
“Men are affected more frequently than women (3.0% vs. 2.6%) in all age groups, suggesting that SD may be associated with sex hormones such as androgens [1,3,8].”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [3]
In the paper’s continuing-education questions (section labeled “Medicações tópicas,” page unavailable), an item links seborrheic dermatitis with sex hormones, citing its occurrence in newborns and return in adolescence. The copy does not specifically identify androgens as the hormones involved; its treatment discussion mentions antiandrogenic effects of antifungals only as a debated possibility. (LLM, conf=0.82)
Experimental — accuracy not yet measuredIn immune-suppressed patients, SD is often more extensive, intense, and refractory to treatment.
“In immune-suppressed patients, SD is often more extensive, intense, and refractory to treatment [3,26,30].”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [3]
The “Dermatite seborreica e HIV” section says seborrheic dermatitis in HIV-positive patients can be more extensive, intense, and refractory to conventional treatment. It does not establish that this is often the case across immune-suppressed patients generally. (LLM, conf=0.84)
Experimental — accuracy not yet measuredSystemic therapy is needed only in widespread lesions and in cases that do not respond to topical treatment.
“Systemic therapy is needed only in widespread lesions and in cases that do not respond to topical treatment [3,26].”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [3]
The “Medicações tópicas” section says oral medicines can be used mainly for extensive seborrheic dermatitis that is refractory to topical medicines. This supports systemic treatment in those circumstances, but does not say it is needed or that its use is limited to them. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Histologically, acute and sub-acute SD shows superficial perivascular and perifollicular inflammatory infiltrates, composed mainly of lymphocytes and histiocytes, with spongiosis and psoriasiform hyperplasia, and shoulder parakeratosis.
“In the acute and sub-acute stages, SD shows superficial perivascular and perifollicular inflammatory infiltrates, composed mainly of lymphocytes and histiocytes in association with spongiosis and psoriasiform hyperplasia, and can be coupled with parakeratosis around follicular opening (“shoulder parakeratosis”).”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [3]
The HISTOPATOLOGIA section describes acute and subacute seborrheic dermatitis with an infiltrate mainly of lymphocytes and histiocytes, spongiosis, mild-to-moderate psoriasiform hyperplasia, and parakeratosis around follicular openings (“shoulder parakeratosis”). It does not specify that the infiltrate is superficial perivascular and perifollicular. No page number is available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe main differential diagnosis of SD and dandruff includes psoriasis, atopic dermatitis, tinea capitis, rosacea, and systemic lupus erythematous (SLE).
“The main differential diagnosis of SD and dandruff includes psoriasis, atopic dermatitis (mainly in the pediatric form of SD), tinea capitis, rosacea, and systemic lupus erythematous (SLE) [3,7,8] (Table 2).”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [3]
The Differential Diagnosis section lists psoriasis, atopic dermatitis (especially in pediatric seborrheic dermatitis), and tinea capitis, and says facial lesions can resemble rosacea and acute cutaneous lupus erythematosus. It does not specifically identify systemic lupus erythematosus as the differential diagnosis; the claim substitutes that condition for the cutaneous form named in the paper. No page number is available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredElevated levels of human leukocyte antigens HLA-AW30, HLA-AW31, HLA-A32, HLA-B12 and HLA-B18 have been found in SD.
“Indeed, one study found elevated levels of human leukocyte antigens HLA-AW30, HLA-AW31, HLA-A32, HLA-B12 and HLA-B18 in SD [3,73,74].”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [3]
The SISTEMA HLA section (page unavailable) reports increased frequencies of HLA-AW30 and/or AW31 and HLA-B12 in seborrheic dermatitis. It does not report increased HLA-A32 or HLA-B18, and its “and/or” wording does not establish that both AW30 and AW31 were elevated. (LLM, conf=0.91)
Experimental — accuracy not yet measuredSD and dandruff have a strong time correlation with sebaceous gland activity, with cradle cap after birth, increased incidence throughout the teens, between third and sixth decades, and then decreasing.
“Thus, SD and dandruff have a strong time correlation with SG activity, with cradle cap after birth, increased incidence throughout the teens, between third and sixth decades and then decreasing [3,4,9].”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [3]
The Clinical Diagnosis section (page unavailable) describes seborrheic dermatitis appearing shortly after birth and favoring areas with high sebum production. The paper also describes a return in adolescence, but the passages do not establish the claimed strong age-by-age correlation for both seborrheic dermatitis and dandruff, or a decline after the sixth decade. (LLM, conf=0.82)
Experimental — accuracy not yet measuredSustained reservoirs of residual sebum associated with immobility may influence the manifestation of the disease.
“Because poor hygiene has been implicated in SD, these observations suggest that sustained reservoirs of residual sebum associated with immobility may influence the manifestation of the disease [3,22,26,88].”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [3]
The passage under “Seborrheic dermatitis” says that residual sebum reservoirs, such as those associated with inadequate hygiene, could predispose to seborrheic dermatitis, including in patients with neuropathy. It does not specifically connect those reservoirs to immobility; that part is an inference in the citing sentence. (LLM, conf=0.84)
Experimental — accuracy not yet measuredMost cases of SD in HIV patients are diagnosed with CD4+ T lymphocyte counts between 200 and 500/mm3, and decreased CD4+ counts are often associated with worse SD.
“Most cases of SD in HIV patients are diagnosed with CD4+ T lymphocyte counts between 200 and 500/mm3 [3,14,15], and decreased CD4+ counts are often associated with worse SD.”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [3]
Immunological defects may play a role in SD.
“These observations suggest that immunological defects may play a role in SD.”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [3]
The main complication of SD is secondary bacterial infection, which increases redness and exudate and local irritation.
“The main complication is secondary bacterial infection, which increases the redness and exudate and local irritation [3,15].”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [3]
Chronic SD lesions show marked psoriasiform hyperplasia and parakeratosis with dilation of the venules of surface plexus, resembling psoriasis.
“On the other hand, in chronic lesions, marked psoriasiform hyperplasia and parakeratosis can be present with dilation of the venules of surface plexus which resembles psoriasis [3,4,38].”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [3]
Men are affected more frequently than women (3.0% vs. 2.6%) in all age groups.
“Men are affected more frequently than women (3.0% vs. 2.6%) in all age groups, suggesting that SD may be associated with sex hormones such as androgens [1,3,8].”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [3]
The Abstract (page unavailable) gives an overall prevalence of 1–3% and describes age-related incidence, but does not compare men with women. Searches of the indexed full text for sex-specific prevalence, 3.0%, and 2.6% did not locate the claimed comparison across all age groups. (LLM, conf=0.69)
Experimental — accuracy not yet measuredNo apparent differences were observed in SD incidence between ethnic groups.
“No apparent differences were observed in SD incidence between ethnic groups [3].”
From Seborrheic Dermatitis and Dandruff: A Comprehensive Review (2015) · cites this paper as [3]
The epidemiology quiz in the indexed copy (section labelled “Medicações tópicas:”, page unavailable) includes ‘não há diferença entre raças’ only as part of a combined answer option that the answer key does not select. Searches for race, ethnicity, and racial predilection found no passage establishing whether SD incidence differs between ethnic groups. (LLM, conf=0.68)
Experimental — accuracy not yet measured
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Cites
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Satchell, A. C., Saurajen, A., Bell, C., & Barnetson, R. S. (2002) · Journal of the American Academy of Dermatology · doi:10.1067/mjd.2002.122734 · Cited by 152 · see citing works
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Plotkin, L. I., Squiquera, L., Mathov, I., Galimberti, R., & Leoni, J. (1996) · Medical Mycology · doi:10.1080/02681219680000071 · Cited by 53 · see citing works
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- Ana Luisa Sobral Bittencourt Sampaio Rua Almirante João Cândido Brasil, 72/102 - Tijuca 20511-020 Rio de Janeiro, RJ E-mail: analuisasbs@gmail.com Como citar este artigo/How to cite this article: Sampaio ALB, Mameri A, Jeunon T, Ramos-e-Silva M, Nunes AP, Carneiro S. Dermatite seborreica. An Bras Dermatol. 2011;86(6):1061-74.
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- Authors
- Sampaio, A. L. S. B., Mameri, Â. C. A., Vargas, T. J. D. S., Ramos-e-Silva, M., Nunes, A. P., & Carneiro, S. C. D. S.
- Affiliations
- Universidade Federal do Rio de Janeiro (BR)
- Clínica Medicina Especializada, Brasil
- Hospital Geral de Bonsucesso (BR)
- Universidade Federal do Rio de Janeiro, Brasil
- Venue
- Anais Brasileiros de Dermatologia
- Publisher
- FapUNIFESP (SciELO)
- Published
- 2011-12
- Volume
- 86
- Issue
- 6
- Pages
- 1061-1074
- ISSN
- 0365-0596 (ISSN-L)
- OpenAlex
- W3209065031
- Cited by
- 103
- References
- 3
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 9 · 2023: 6 · 2022: 11 · 2021: 11 · 2020: 12 · 2019: 12 · 2018: 3 · 2017: 5 · 2016: 3 · 2015: 5 · 2014: 6 · 2013: 6 · 2012: 3
- FWCI
- 3.60
- Type
- journal article
- Language
- pt
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- Anais Brasileiros de Dermatologia (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- Americanae (AECID Library) (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Universidade Federal do Rio de Janeiro
- Topics
- Health Sciences › Medicine › Epidemiology › Nail Diseases and Treatments
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Medicine › Urology › Hair Growth and Disorders
- Keywords
- seborrheic dermatitis, Malassezia, pathogenesis, unsaturated fatty acids, immunogenetics, clinical forms, treatment, prevalence, HIV, neurological disorders
- MeSH terms
- Acquired Immunodeficiency Syndrome, Dermatomycoses, Diagnosis, Differential, Humans, Malassezia, Dermatitis, Seborrheic, HIV Infections
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