Coexistence of Alopecia Areata and Seborrheic Dermatitis: A Case Report
DOI:
https://doi.org/10.35790/msj.v8i1.59549Abstract
Abstract: Alopecia areata is an autoimmune hair disorder that causes bald patches. AA occurs at all ages with a slightly greater tendency in women. Diagnosis is usually clinical but in atypical cases such as ophiasis, supporting examinations such as trichoscopy or skin biopsy can be performed. Seborrheic dermatitis (SD) is an inflammatory skin disease with scales in areas full of sebaceous glands such as the scalp. Factors that play a role in the pathogenesis of SD include decreased immunity and the role of Malassezia. The diagnosis of SD is usually based on clinical. SD and AA can occur alone or together. In this report, a 44-year-old man came with complaints of patchy hair loss on the scalp for four years accompanied by itchy and scaly red patches on the scalp in the last one month. Based on the history and physical examination, the diagnosis of alopecia areata and seborrheic dermatitis was established. Intralesional corticosteroids, a combination cream of clobetasol and ketoconazole, and loratadine is given. After one week, improvement was seen with the disappearance of scales redness, and hair growth within four weeks of treatment. In conclusion, the treatment performed showed good results to overcome both conditions.
Keywords: alopecia areata; intralesional corticosteroid; seborrheic dermatitis
References
1. Otberg N, Shapiro J. Alopecia Areata. In: Edmonson KG, Davis KJ, editors. Fitzpatrick’s Dermatology (9th ed). New York: McGraw Hill; 2019. p. 1517–22.
2. Lee Y, Kim K, Lew BL, Huh CH, Kang H, Jang YH, et al. Factors affecting the response and patient satisfaction of topical immunotherapy in alopecia areata: a nationwide study. Ann Dermatol. 2024;36(4):225. Doi: https://doi.org/10.5021/ad.23.138
3. Leong WMS, Mok ZR, Chandran NS. Limited efficacy of diphenylcyclopropenone in the treatment of alopecia areata: Experience from a tertiary healthcare institution in Singapore. Dermatol Ther. 2020;33(6). Doi: https://doi.org/10.1111/dth.14447
4. Gregoire S, McIntosh B, Sanchez K, Biba U, Mostaghimi A. Local corticosteroids for alopecia areata: a narrative review. Dermatol Ther (Heidelb). 2025;15(7):1607–31. Doi: 10.1007/s13555-025-01421-2
5. Lensing M, Jabbari A. An overview of JAK/STAT pathways and JAK inhibition in alopecia areata. Front Immunol. 2022;13:955035. Doi: https://doi.org/10.3389/fimmu.2022.955035
6. Otberg N,Shapiro J. Seborrheic Dermatitis (9th ed). In: Edmonson KG, Davis KJ, editors. Fitzpatrick’s Dermatology. New York: McGraw Hill; 2019. p. 428–37.
7. Gaurav V, Bahadur A, Tyagi H. Role of dermoscopy in differentiating seborrheic dermatitis of scalp and scalp psoriasis. Cosmoderma. 2024;4:80. Doi:10.25259/CSDM_101_2024
8. Darwin E, Hirt P, Fertig R, Doliner B, Delcanto G, Jimenez J. Alopecia areata: review of epidemiology, clinical features, pathogenesis, and new treatment options. Int J Trichology. 2018;10(2):51. Doi: 10.4103/ijt.ijt_99_17
9. Ma T, Zhang T, Miao F, Liu J, Zhu Q, Chen Z, et al. Alopecia areata: pathogenesis, diagnosis, and therapies. MedComm (Beijing). 2025;6(5):1-30. Doi: 10.1002/mco2.70182
10. Rastaghi F, Kaveh R, Yazdanpanah N, Sahaf AS, Ahramiyanpour N. Efficacy and adverse effects of corticosteroid pulse therapy in alopecia areata. Dermatol Pract Concept. 2023;13(4):e2023255. Doi: 10.5826/dpc.1304a255
11. Shakoei S, Seifi G, Ghanami F, Ghandi N, Hamzelou S, Nasimi M, et al. Clinical and demographic characteristics associated with nail involvement in alopecia areata: a cross‐sectional study of 197 patients. Health Sci Rep. 2024;7(4):e2020. Doi: 10.1002/hsr2.2020
12. Andre N, Weissmann S, Cohen B, Gordon CB, Nassar M, Kestenbom I, et al. Hematological ratios as an indicator of severity in alopecia areata: a retrospective nationwide study. PLoS One. 2024;19(12):e0314600. Doi: 10.1371/journal.pone.0314600
13. Sibbald C. Alopecia areata: an updated review for 2023. J Cutan Med Surg. 20230;27(3):241–59. Doi: 10.1177/12034754231168839
14. Marahatta S, Agrawal S, Adhikari BR. Psychological impact of alopecia areata. Dermatol Res Pract. 2020;2020:1–5. Doi: 10.1155/2020/8879343
15. King BA, Mesinkovska NA, Craiglow B, Kindred C, Ko J, McMichael A, et al. Development of the alopecia areata scale for clinical use: results of an academic–industry collaborative effort. J Am Acad Dermatol. 2022;86(2):359–64. Doi: 10.1016/j.jaad.2021.08.043
16. Saunte DML, Gaitanis G, Hay RJ. Malassezia-associated skin diseases, the use of diagnostics and treatment. Front Cell Infect Microbiol. 2020;10:112. Doi: 10.3389/fcimb.2020.00112
17. Dall’Oglio F, Nasca MR, Gerbino C, Micali G. An overview of the diagnosis and management of seborrheic dermatitis. Clin Cosmet Investig Dermatol. 2022;15:1537–48. Doi: 10.2147/CCID.S284671
18. Akbulut TO. Is the frequency of seborrheic dermatitis related to climate parameters? SiSli Etfal Hastanesi Tip Bulteni/The Medical Bulletin of Sisli Hospital. 2022;56(1):91-95. Doi:10.14744/SEMB.2021.67503
19. Galizia G, Belloni Fortina A, Semenzato A. Seborrheic dermatitis: from microbiome and skin barrier involvement to emerging approaches in dermocosmetic treatment. Cosmetics. 2024;11(6):208. Doi: 10.3390/cosmetics11060208
20. Piacentini F, Camera E, Di Nardo A, Dell’Anna ML. Seborrheic dermatitis: exploring the complex interplay with Malassezia. Int J Mol Sci. 2025;26(6):2650. Doi: 10.3390/ijms26062650
21. Cheng Y, Cong J, Xu J, Tang L, Zhou Z, Yang X, et al. Research progress on the exacerbation of lipid metabolism by Malassezia and its impact on the skin barrier function. Cosmetics. 2025;12(2):67. Doi: 10.3390/cosmetics12020067
22. Honnavar P, Chakrabarti A, Joseph J, Thakur S, Dogra S, Lakshmi PVM, et al. Molecular epidemiology of seborrheic dermatitis/dandruff associated Malassezia species from northern India. Med Mycol. 2024;62(10). Doi: 10.1093/mmy/myae104
23. Park JH, Park YJ, Kim SK, Kwon JE, Kang HY, Lee ES, et al. Histopathological differential diagnosis of psoriasis and seborrheic dermatitis of the scalp. Ann Dermatol. 2016;28(4):427. Doi: 10.5021/ad.2016.28.4.427
24. Passeron T, King B, Seneschal J, Steinhoff M, Jabbari A, Ohyama M, et al. Inhibition of T-cell activity in alopecia areata: recent developments and new directions. Front Immunol. 2023;14:1-12. Doi: 10.3389/fimmu.2023.1243556
25. Zengin S, Guthrie J, Zoumberos N, Hamza M, Shalin SC. Sebaceous gland atrophy due to seborrheic dermatitis in a patient with alopecia: a potential pitfall. J Cutan Pathol. 2024;51(7):513–7. Doi: 10.1111/cup.14623
26. Mia MT. Alopecia: updated management. Bangladesh Journal of Medicine. 2024;137. Doi: 10.3329/bjm.v35i20.73384
27. Müller Ramos P, Anzai A, Duque-Estrada B, Melo DF, Sternberg F, Santos LDN, et al. II Consensus of the Brazilian Society of Dermatology for the treatment of alopecia areata. An Bras Dermatol. 2025;100(2):328–41. Doi: 10.1016/j.abd.2024.10.001
28. Park H, Kim JE, Choi JW, Kim DY, Jang YH, Lee Y, et al. Guidelines for the management of patients with alopecia areata in Korea: Part II Systemic Treatment. Ann Dermatol. 2023;35(3):205. Doi: 10.5021/ad.22.167
29. Fatani MIA, Alkhalifah A, Alruwaili AFS, Alharbi AHS, Alharithy R, Khardaly AM, et al. Diagnosis and management of alopecia areata: a Saudi Expert Consensus Statement (2023). Dermatol Ther (Heidelb). 2023;13(10):2129–51. Doi: 10.1007/s13555-023-00991-3
30. Wang L, Liu H, Li N, Wang Y, Liu Q, Zheng Y, et al. Effectiveness and tolerance of medicated shampoo containing selenium sulfide and salicylic acid in patients with seborrheic dermatitis. Journal of Dermatological Treatment. 2025;36(1). Doi: 10.1080/09546634.2025.2506676
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