Seborrheic

The conditions whereby dandmff, seborrheic dermatitis, and psoriasis dmg products are generally recognized as safe and effective and are not misbranded is available (70). Specific active iagredients that can be used as well as the statement of identity, iadications for use, and required warnings, are identified. Products that do not meet all of these requirements are considered new dmgs and must have an approved NDA for the nonmonograph conditions. 

Medicine and Nutrition. A stabilized buffered suspension of selenium sulfide has been marketed for many years as Selsun Blue (Abbott Laboratories) for control of seborrheic dermatitis of the scalp. A similar sulfur or selenium sulfide shampoo containing a metallic cation complex has been prepared (122). Topical appHcation of selenium sulfide controls dermatitis, pmritis, and mange iu dogs (see Cosmetics Veterinarydrugs). 

Ketoconazole. Initial observations indicating that oral administration of ketocona2ole (10) produced good results in seborrheic ec2ema and dandruff, led to the development of a 2% cream and a 2% shampoo (scalp gel) of this antimycotic (17,18). Naturally, these two topical forms of ketocona2ole [65277-42-1] are highly active against superficial mycoses. 

The main application of these two topical forms is the treatment of seborrheic ec2ema and dandruff. Ketocona2ole s potent pityrosporicidal effect at concentrations of 100 ng/mL to 1 p.g/mL forms the rationale of this activity. 

Another compound, the antimicrobial action of which is associated with chelation, is 2-pyridinethiol-A/-oxide [3811-73-2] (Omadine). Activity has been shown to depend on coordinating property. The iron chelate is active, but not the free pyridine compound (200). In the form of its zinc chelate it is found in shampoos to control seborrheic dermatitis (201). Other appHcations of this useful chemical include preservation of adhesives, plastics, latex paints, polyurethane foam, and metal working fluids (202). 

The excessive production of sebum associated with acne has made life miserable for many an adolescent. Research on acne has, as a rule, concentrated on therapy rather than prophylaxis. A pyrimidone forms an interesting exception, being described as an anti seborrheic agent. Starting keto-ester 21 can, at least in principle, be obtained by y-... 

Pemphigus, bullous dermatitis herpetiformis, severe erythema multiforme (Stevens-Johnson syndrome), exfoliative dermatitis, mycosis fungoides, severe psoriasis, severe seborrheic dermatitis, angioedema, urticaria, various skin disorders, such as lichen planus or keloids... 

Epidermal growths including actinic keratoses and thin seborrheic keratoses... 

Epidermal growths such as actinic keratosis, lentigines or thin seborrheic keratoses can all be treated effectively with 25-35% TCA peels. Thicker epidermal growths or growths involving the dermis will be more resistant to treatment such as hypertrophic actinic keratoses and thicker seborrheic keratoses and may even be resistant to a medium-depth peel. Resistant lesions many times are best treated with a combination of a medium-depth chemical peel and other modalities such as manual dermasanding or CO, laser. 

Seborrheic keratoses Hypertrophic keratoses Mixed melasma Mixed hyperpigmentation... 

Br Riboflavin Coenzyme in oxidation and reduction reactions prosthetic group of flavoproteins Lesions of corner of mouth, lips, and tongue seborrheic dermatitis... 

Although riboflavin is fundamentally involved in metabolism, and deficiencies are found in most countries, it is not fatal as there is very efficient conservation of tissue riboflavin. Riboflavin deficiency is characterized by cheilosis, lingual desquamation and a seborrheic dermatitis. Riboflavin nutritional status is assessed by measurement of the activation of erythrocyte glutathione reductase by FAD added in vitro. 

The word dermatitis denotes an inflammatory erythematous rash. The disorders discussed in this chapter include contact dermatitis, seborrheic dermatitis, diaper dermatitis, and atopic dermatitis. Drug-induced skin disorders have been associated with most commonly used medications and may present as maculopapular eruptions, fixed-drug eruptions, and photosensitivity reactions. 

Seborrheic dermatitis typically occurs around the areas of skin rich in sebaceous follicles (e.g., the face, ears, scalp, and upper trunk). In infants with involvement ofthe scalp, the condition is commonly referred to as cradle cap. Diaper dermatitis results in erythematous patches, skin erosions, vesicles, and ulcerations. Although commonly seen in infants, it can occur in adults who wear diapers for incontinence. 

Therapeutic goals for seborrheic dermatitis are to loosen and remove scales, prevent yeast colonization, control secondary infections, and reduce itching and erythema. 

The physiologic sequelae of biotin deficiency are almost unexplored. Severe skin lesions, especially seborrheic dermatitis and Leiner s disease (Erythroderma desquamativum or exfoliative dermatitis), were increased in young infants bom of mothers on a restricted diet low in eggs, livers, and other biotin-rich foods. After biotin administration the lesions healed. There are claims that excess biotin produces a fatty liver characterized by heightened cholesterol content. Choline has no effect in the prevention of biotin-fatty livers (G2, M2). In mice with transplanted tumors, both the tumors and the blood levels of biotin are below normal (R8). More recent studies established a protection with avidin, the biotin-binding fraction of egg white, against tumor formation (K4). More data along these lines are still needed for confirmation. 

Dermatologic diseases Pemphigus bullous dermatitis herpetiformis severe erythema multiforme (Stevens-Johnson syndrome) mycosis fungoides severe psoriasis angioedema or urticaria exfoliative, severe seborrheic, contact, or atopic dermatitis. 

Dermatologic lesions 40 to 120 mg IM weekly for 1 to 4 weeks. In severe dermatitis, relief may result within 8 to 12 hours of a single dose of 80 to 120 mg IM. In chronic contact dermatitis, repeated injections every 5 to 10 days may be necessary. In seborrheic dermatitis, a weekly dose of 80 mg IM may be adequate. 

Alternative/Adjunctive treatment Psoriasis, seborrheic dermatitis, severe diaper rash, dishidrosis, nodular prurigo, chronic discoid lupus erythematosus, alopecia areata, lymphocytic infiltration of the skin, mycosis fungoides, and familial benign pemphigus of Hailey-Hailey. 

Nonprescription hydrocortisone preparations Temporary relief of itching associated with minor skin irritations, inflammation, and rashes caused by eczema, insect bites, poison ivy, poison oak, poison sumac, soaps, detergents, cosmetics, jewelry, seborrheic dermatitis, psoriasis, and external genital and anal itching. 

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