What Is Sebopsoriasis?

Sebopsoriasis is a disease that has symptoms of two different skin conditions: psoriasis and seborrheic dermatitis. Psoriasis is an autoimmune disorder that causes a red rash with dry, scaly patches (plaques). Seborrheic dermatitis is a common skin condition that appears as a scaly rash on oily areas of the body like the face and scalp.

Sebopsoriasis presents as a red rash with yellow, greasy scales in areas of the body where seborrheic dermatitis typically appears (scalp, face, chest, and within skin folds).

Although anyone at any age can be diagnosed with sebopsoriasis, the condition is more prevalent in children, adolescents, and people 50 years of age or older.  Men also tend to have a higher tendency of getting sebopsoriasis than women.

Sebopsoriasis Symptoms

Common symptoms of sebopsoriasis include:

• Dry, flaking scales
• Itchiness
• Yellow-gray tinged, greasy scales located on the scalp, eyebrows, and behind the ears, as well as in the folds of the face and over the breastbone
• Scales that are thicker, more reddened, and have more defined borders compared to scales associated with normal seborrheic dermatitis
• Scales that are not as silvery in color as the scales present in psoriasis
• A rash found in the skinfolds, such as in the fold behind the ears

Both scalp psoriasis and seborrheic dermatitis can cause minor hair loss from inflammation and aggressive scratching. Therefore, it may be possible for hair loss to occur if sebopsoriasis affects the scalp.

Causes

The exact cause of sebopsoriasis is not well known. Factors that may trigger seborrheic dermatitis include:

• Stress
• Dry weather
• Skin irritants
• A Western-style diet that is high in meat and processed foods

Sebopsoriasis is also associated with symptoms of psoriasis. The cause of psoriasis is not well understood. Sebopsoriasis is thought to be an immune system condition that creates an increase in the rate of skin cell turnover (old skin cells being shed and subsequently replaced with new cells), scaling, and inflammation (as seen in psoriasis).

The reason for this immune system malfunction is not well understood. Genetics and environmental factors are thought to play a role in the development of psoriasis. A family history of psoriasis and/or seborrheic dermatitis is associated with sebopsoriasis.

Factors that are linked to increased severity of sebopsoriasis include:

• Immunosuppression from conditions such as chronic liver disease or human immunodeficiency virus and the disease it causes (HIV/AIDS)
• Psychiatric and neurological illnesses, including Parkinson's disease
• Cancer

Diagnosis

There are several ways that sebopsoriasis can be diagnosed, including from:

• A thorough history of symptoms
• The clinical presentation noted upon a physical exam
• A small sample of the skin (skin biopsy)—which is rarely ordered—to look for features of the cells that may reveal the illness
• A skin scraping for lab evaluation to determine the presence of certain types of yeast or bacteria (This may not be an inclusive diagnosis because these organisms naturally reside on the skin as part of its flora, or microbiome.)

Treatment

Several types of treatments may be used for sebopsoriasis. Many of the treatment options overlap with typical treatments for psoriasis and treatments for seborrheic dermatitis.

Many times, the way a person responds to treatment sends up red flags about which disorder a person is most likely to have, and the diagnosis often can change from sebopsoriais to either psoriasis or seborrheic dermatitis.

Treatments can include:

• Emollients: Moisturizers containing ingredients that keep the skin soft and help prevent cracking. These include creams, ointments, lotions, gels, and sprays.
• Topical keratolytics: Preparations that are applied directly to the skin to help dissolve flakes and scales.
• Topical creams with antifungal properties: These include creams containing ketoconazole or zinc pyrithione, which are known to be effective at treating seborrheic dermatitis but are not known to help with the symptoms of psoriasis.
• Topical corticosteroids: These function to reduce inflammation and help relieve itchiness.
• Combination treatments: Sometimes combination treatments are used to treat sebopsoriasis. These agents are made up of topical corticosteroids combined with ketoconazole shampoo. They are often more effective than the use of one type of medication alone for the treatment of sebopsoriasis.
• Topical calcineurin inhibitors: These may be used to manage long-term symptoms of sebopsoriasis. Topical calcineurin inhibitors work on immune cells to interfere with substances that contribute to skin inflammation. They also are effective at inhibiting the release of histamine, which helps to stop itching.
• Vitamin D–like compounds: These include preparations such as tacalcitol ointment and calcipotriol. Calcipotriol is a vitamin D derivative that helps to lessen the skin’s inflammatory response as well as reduce symptoms of scaling in sebopsoriasis. Rapid skin cell reproduction occurs when a person has psoriasis. Vitamin D–like preparations work by slowing down the overproduction of skin cells. This, in turn, helps to ease inflamed, scaly areas of the skin.
• Coal tar products: These topical products are often used for plaque psoriasis and seborrheic dermatitis. They work by reducing inflammation and dissolving skin flakes and scales.
• Phototherapy: This type of therapy, which exposes the skin to light, can be effective for some people with psoriasis on the face. This treatment may be considered for resistant sebopsoriasis.

Prognosis

Sebopsoriasis is a chronic (long-term) condition that involves periods of remission (times when symptoms disappear or decrease) and flare-ups (worsening of symptoms). The prognosis of sebopsoriasis can vary greatly depending on a number of factors, including the severity of the disease and the prevalence of symptoms for seborrheic dermatitis or for psoriasis.

Over time, people with sebopsoriasis may exhibit more symptoms of psoriasis and fewer symptoms of seborrheic dermatitis.  Additional studies are needed to evaluate the long-term outcome/prognosis of sebopsoriasis treatment.

Summary

Sebopsoriasis is a disease that has symptoms of two different skin conditions: psoriasis and seborrheic dermatitis. Treatment options can vary, so if you have sebopsoriasis, talk over your options with your healthcare provider.