Teaching Bangsal Dermatitis Seboroik

8/11/2019 Teaching Bangsal Dermatitis Seboroik

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TEACHING BANGSAL

SEBORRHEIC DERMATITIS


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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


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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


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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.


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Systematical Anamnesis :

Fever (-),

Cough (-), chest pain (-), nausea (-), vomit (-)

Defecation : normal

Urination : normal


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History of similar disease : (+)

9 months ago, given treatment with baby powder for 3 daysand recovered

Family History with the same complaint : ( - )

Treatment history : (-)

Lifestyle : smoking (+), alcohol (+)

Allergic : (-)

Systemic disease : (-)


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PRESENT STATUS

General condition : Moderate Illness

Consciousness : Compos mentis

Vital sign :

BP : 150/100 mmHg

Pulse : 84x/minute,regulerBreathing : 22x/minute

Temperature : 37,00C


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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


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Dermatology Status

- Location : regio scalp

regio facialis

regio retroaurikuler

Efflorescence : yellowish scale

Additional Examination : KOH (-)


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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 patientsweated. 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.


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Vital Sign:

BP: 150/100 mmHg HR: 84x/minute, reguler

R: 22x/minute T: 370C

Dermatology Status :

Location : regio scalp, regio facialis,

regio retroaurikuler

Efflorescence : Yellowish Scale


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DIAGNOSIS

-Seborrheic Dermatitis


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Treatment

- Topical : Mikonazole 2% cream 10mg +Hidrocortison 2,5% cream 5 gr applyface (Morning-Afternoon)

MBO talc spread into body

- Sistemic : Cetirizine 10mg 0-0-1

PROGNOSIS

- Bonam


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DiscussionSeborrheic Dermatitis


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Seborrheic Dermatitis

Chronic papulosquamous condition

Occur on sebum-rich areaof scalp, face and trunk

Characterized by periods of exacerbation and remission inadults.

Epidemiology : all ages, men > women


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Patogenesis

The etiology is unclear

But there are associations with Malassezia yeasts, sebum

secretion and composition.

The activation of sebaseous gland stimulate the increasingproduction of sebum .


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Patofisiologi

Malassezia ecosystem and its interaction with epidermis

Inflammation

Obstruction to the proliferation proccess and epidermisdifferentation

Dysfunction of skin


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Diagnosis

Efflorescence

Erythematous and oily yellowish scale, clearless borderline

Predilection area: occur on sebum-rich areaof scalp, faceand trunk


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Differential Diagnosis

Atopic Dermatitis

Psoriasis


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Additional Treatment

Fungal culture and skin smear can beused to rule out tinea capitis

Serrological examination atopicdermatitis


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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


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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


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- 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


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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 )


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Prognosis

For babies: self limiting disease

For adults: chronic and recurrence.


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Thank you

Teaching Bangsal Dermatitis Seboroik

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