The Correlation between Seborrheic Dermatitis and Low Values of B Complex Vitamins in the Body

Created by: FERDY 030.08.102

Medical Faculty of Trisakti University Jakarta, 8th June 2011

TABLE OF CONTENTS Cover..............................................................................................................................1 Table of Contents...........................................................................................................2 CHAPTER I: Abstract........................................................................................3 Background............................................................................................3 Problems.................................................................................................3 Limitation of problems...........................................................................4 CHAPTER II: Introduction................................................................................5 CHAPTER III: Seborrheic Dermatitis................................................................6 Seborrheic Dermatitis explanation.........................................................6 Seborrheic Dermatitis causes.................................................................6 Seborrheic Dermatitis clinical manifestations........................................7 Seborrheic Dermatitis diagnosed............................................................9 Seborrheic Dermatitis differential diagnosis........................................10 Seborrheic Dermatitis treatment...........................................................12 CHAPTER IV: Low Values of B Complex Vitamins..............................................13 Low Values of B Complex Vitamins explanation................................13 Low Values of B Complex Vitamins causes........................................15 Low Values of B Complex Vitamins symptoms..................................16 Low Values of B Complex Vitamins treatment...................................16 CHAPTER V: CORRELATION BETWEEN SEBORRHEIC DERMATITIS AND LOW VALUES OF B COMPLEX VITAMINS IN THE BODY..........19 CONCLUSION...........................................................................................................20 REFERENCES...........................................................................................................21

Chapter I Abstract
Background I choose this topic because the prevalence of these diseases (seborrheic dermatitis and low values of B complex vitamins) is quite high in Indonesia. The second reason is because of my experience with seborrheic dermatitis in my eyebrows and nasolabial folds. Seborrheic dermatitis is a disease that causes flaking of the skin. It usually affects the scalp. In adolescents and adults, it is commonly called "dandruff." Seborrheic dermatitis can also affect the skin on other parts of the body, such as the face and chest, and the creases of the arms, legs and groin. Seborrheic dermatitis usually causes the skin to look a little greasy and scaly or flaky. Problems Genetic, environmental, hormonal, and immune-system factors have been shown to be involved in the manifestation of seborrheic dermatitis. Seborrheic dermatitis may be aggravated by illness, psychological stress, fatigue, change of season and reduced general health. It may also occur during times of stress or sleep deprivation. In children, excessive vitamin A intake can cause seborrheic dermatitis. Lack of biotin,[pyridoxine (vitamin B6)[ and riboflavin (vitamin B2) may also be a cause. Although many people consume foods fortified with vitamin B, the typical American diet that is high in processed, cooked and microwavable food provides only a fraction of the B-vitamins we need for good health. Because these vitamins are vital to a vigorous long life, not getting them can lead to serious problems. B vitamins are easily flushed out of the body, and people on weight-loss diets, alcoholics or those who take antibiotics or seizure drugs are even more inclined to have vitamin B deficiency. 3

While it is safe for many people to take three times or more of the RDA (Recommended Daily Allowance) for B-vitamins, each of us has unique requirements based on our own individual physiology and lifestyle. Consequently, it is important to check with a knowledgeable health professional before beginning a vitamin regimen in order to determine your proper dosage. Because deficiencies usually include more than one B-vitamin, and because the B-vitamins work best as a team, we should take a B-complex supplement along with any single B-vitamin in order to achieve their synergistic effects. Limitation of problems Learning about seborrheic dermatitis:

What is seborrheic dermatitis? What causes seborrheic dermatitis? What are the clinical manifestations of seborrheic dermatitis?

Being diagnosed:

How is seborrheic dermatitis diagnosed? What are the differential diagnosis?

Getting treatment:

How is seborrheic dermatitis treated?

Learning about low values of B complex vitamins in the body:

What is low values of B complex vitamins in the body? What causes low values of B complex vitamins in the body? What are the symptoms of low values of B complex vitamins in the body?

Being diagnosed:

How is low values of B complex vitamins diagnosed?

Getting treatment:

How is low values of B complex vitamins treated?

Chapter II Introduction

This paper was conducted for the purpose of providing information to those unaware and unfamiliar with the concepts and issues surrounding privacy and information about the correlation between seborrheic dermatitis and low values of B vitamin complex in the body. It should offer resources for further research and exploration as it pertains to the readers needs. For those who are already familiar with the topic, this paper would probably be more useful. Seborrheic dermatitis is a chronic inflammatory condition of the skin that can manifest at several stages in life. It is most common in infancy from birth to three years. At this stage the disease is called cradle cap. The disease is not contagious in infants and usually disappears within twelve months. Seborrheic dermatitis at this stage is seldom itchy or irritating, but if scratched, the skin can become more prone to other infections. The second stage of life where seborrheic dermatitis can occur is post puberty. The disease manifests as itchy irritable skin with visible flakes. It mainly is found on the head, face and neck and may be believed to be a bad case of dandruff. Stress seems to be a factor in the severity of the disease at this age. The third stage where seborrheic dermatitis becomes prevalent is between the ages of 30 to 60. Men seem to be more plagued with this disease than women. At this age the disease can be found on the head or any part of the trunk of the body. It can vary from a mild rash to very inflamed, itchy scaly skin. The vitamin B group includes B1 (thiamin), B2 (riboflavin), B3 (niacin and niacinamide), B6 (pyridoxine), B7 (biotin), B12 (cobalamin), folic acid or folate, pantothenic acid, biotin, inositol, and PABA (para-aminobenzoic acid). Vitamin B complex improves the body's resistance to stress. Aids in digestion, promotes good muscle tone, healthy skin. Vitamin B complex reduces muscle spasms, leg cramps, hand numbness and helps regulate blood pressure. Vitamin B deficiency can cause beriberi, digestive disturbances, degeneration of the sex glands, and neurological problems.

Chapter III Seborrheic Dermatitis

What is seborrheic dermatitis?
Seborrheic dermatitis is a chronic inflammatory condition of the skin 1,2,3 which based on constitutional factors,4,5 often found in hairy skin,1,2,6 especially on scalp, eyebrow and face.1,2

Epidemiology
Prevalence of seborrheic dermatitis is approximately 3-5% population. 2,3 Often found on patient between 20-50 years, male is more than female. Prevalence increases in patient with HIV and often found in people with Parkinson disease. In infants, can be found seborrheic on the scalp which is called Cradle cap.3

What causes seborrheic dermatitis?

The cause is still unknown exactly. 1,4,5 Only found overproduction of sebaceous glands in infants and teenagers after puberty.1,2 Predisposition factor is constitution anomally formed seborrheic state which inherited, the mechanism is still unknown.5 Many experiments have been done to associate this disease with bacterial infection or Pityrosporum ovale (Malassezia ovale)1,2,3,5,6 which is normal flora in human skin. Overgrowth P.ovale can cause an inflammation reaction, 2,3,5 either effect of the metabolite products that enter into the epidermal, or because of the fungal itself, through lymphocyte T cell activation and Langerhans cell.5 Seborrheic dermatitis is closely related to sebaceous gland liveliness. The Gland is activated when infants borned, then deactivated for 9-12 years because of androgen hormone from mother is stopped. Seborrheic dermatitis in infants happened

around the first months, rarely before puberty and the incidences reach the peak at age 18-40 years, sometimes at old ages, more often happen in men than women.5 Many factors suspected as causes of this diseases, like stress factor, 3 climate, genetic, environmental, food such as lack of B complex vitamins in the food, hormone, dan neurologic.1

What are the clinical manifestations?

Seborrheic dermatitis has predilection in hairy regions, 1,2,6 because plenty of sebaceous glands, are scalp, retroauricular, eybrows, eyelashes, nasolabial folds, ears, neck, chest, fold regions, axillary, inguinal, gluteal, under breast.1,3,4 The distribution is usually bilateral and symmetrical in the form of spots or plaque with no clear boundaries, mild and moderate erythema, oily squama and yellowish. 1,5 Seborrheic dermatitis rarely cause hair falls. Occur composition change of sebaceous glands product, so that commensal bacteria on skin can proliferate well, such as Pityrosporum ovale.

Distribution of seborrheic dermatitis The rashes are different, often found on oily skin. The rash formed oily squama, yellowish color, with no clear boundaries1,5 and red colored base ( erythema ).1 In mild seborrheic dermatitis, only found squama in the scalp. Squama is white colored and prevail without erythem,1 then affect all of the scalp with smooth and rough squamas. This disorder is called pitiriasis sika (dandruff). Oily form called pitiriasis steatoides which are accompanied by erythema and thick crusty lesion. Hair on that place has a tendency to fall out, started in vertes region and frontal.5

Severe seborrheic dermatitis signed with presence of squamous and oily spots accompanied by exudation and thick crust. 5 Could affect eyebrows, forehead, bridge of the nose, presternal are, region between scapula 1, and neck.5 Mild blefaritis often occured.1,5 In more severe form, all of the scalps covered by dirty crusts, and smells bad. In infants, yellowish squamas and lot of debris that sticked on scalp is called cradle cap. Seborrheic dermatitis could together with severe acne. If it spreads can be erytroderm, in infants called Leiner disease.5 According region of the lesion, seborrheic dermatitis is divided into three:1 1. Scalp Seborrheic In hairy skin, found oily squama with yellowish colored so that hair becomes sticky; sometimes found crust that called Pityriasis Oleosa (Pityriasis steatoides).5 Sometimes the squama is dry and layered and often loose itself, called Pityriasis sika (dandruff5). This kind of seborrheic can cause hair falls, so that will be bald and itchy. The spread can reach into retroauricular. If it spreads, the lesion can reach into forehead, called korona seboroik. Seborrheic dermatitis which found in infants scalp is called Cradle Cap.1,5

2. Face Seborrheic In mouth area, palpebral, nasolabial folds, chin, etc, found macula erythematous, which on it are found oily squama yellowish colored. If it reach into the palpebral, can cause blefaritis. 1,5 Often found in women. If found in hairy region, such as chin and upper lip, can occur folliculitis. This thing often

found in men who always shave his beard and mustache. Face seborrheic in beard area is called sikosis barbe.

3. Body and Folds Seborrheic These types involve presternal area, interscapula, axillary, under breast, umbilicus, crural (thigh, perineal). Its seen rash forms macula erythema which found oily yellowish squama on its surface. In the body, the lesion can shape like a circle with central healing. In intertriginous area, sometimes can appear fissure that cause secunder infection.

How is seborrheic dermatitis diagnosed?

Histological findings of seborrheic dermatitis are not spesific, its varieted according to the stage of the disease. On epidermal, there are parakeratosis dan akantosis. In corium, there are dilated blood vessels and perivasculer spurt. In acute stage and subacute, epidermal had ortokeratosis, parakeratosis, also spongiosis. At the edge of the widen and clogged by a mass of keratin hair follicles estuary, found mound of parakeratosis which contained neutrofil. This finding is a characteristically finding. At the upper dermis, there is a mild perivascular lymphohistiocytic spurt. In chronic stage, the finding is almost same as the finding in psoriasis.1

What are the differential diagnosis?

1. Psoriasis1,2,3,5 In psoriasis, there are thick, rough, layered, pearly white and oilness squamas, accompanied by dripping wax and Auspitz sign. The predilection is different too. If the psoriasis affects scalp, it will be difficult to be distinguished with seborrheic dermatitis. The differences are thicker and white mica squama, skin disorders are also at the boundary face and scalp and the other places according to the predilections. Inverse psoriasis which affects flexor area is resemble such as seborrheic dermatitis.5

Psoriasis 2. Pitiriasis rosea1

Seborrheic Dermatitis

In pitiriasis rosea, the squama is smooth and not oily. The lesion is in parallel with the skin line. 3. Tinea capitis1,2,3 In tinea capitis, seen alopecia, sometimes found kerion. In tinea capitis, erythema is more prominent on the edge and the edge is more active than the center. It could be distinguished with culture or KOH (which found long hyphae in tinea capitis).6

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Tinea Capitis 4. SLE with Butterfly rash2,3

Seborrheic Dermatitis

Usually doesnt affect eyebrow, and in SLE abnormal blood laboratory finding is found.

5. Rosasea2,3 Erythema on face, disorders such papules and pustules. 6. Kandidosis5 Theres vermilion erythema firmly bounded with satelites around.

Kandidosis

Dermatitis Seboroik

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How is it treated?
Cases which already had constitutional factors are difficult to cure, even the disease could be controlled. Predisposition factors should be noticed, such as emotional stress and lack of sleep. About diet, low fat and food with B2 (riboflavin), B6 (pyridoxine), B7 (biotin) are suggested.1,5 Topical Treatment Use shampoo that contains sulfur and selenium sulfid 2%1,2,3,6, 2-3 times a week for 5-10 minutes. Can also be given shampoo that contains sulfur, salicylic acid, zing pirition 1-2%.1 Corticosteroid,1,2,3,5,6 such as hidrocortisone cream 2 %. In case with severe inflamation can be used stronger corticosteroid, such as betametasone valerat, dont use for a long term because of the side effects.5 In infants can be given salicylic acid 2-5% in mineral oil.1 Ketoconazole cream 2%2,3,5,6 that can be applicated, when in direct preparations there are many P.ovale5 Resorcine 1-3%5 Systemic Treatment Corticosteroid is used in severe form, prednisone dose is 20-30mg a day. If there is an improvement, dose will be tappering off. If it comes with secunder infection, give antibiotics.5 Isotretinoin can be used in recalcitrant case. The effect is reduce sebaceous gland activity. The gland size could be reduced until 90%, so sebum production is decreased. The dose is 0,1-0,3 mg/kg body weight a day, improvemnet will be seen after 4 weeks. After that, maintenance dose 5-10 mg a day for several years which evidently effective to control the disease. In severe seborrheic dermatitis can be treated with narrow band UVB (TL01) which quite safe and effective. After having treat 3 times a week for 8 weeks, most of patients have improved.5 Can be given antihistamines or sedatives.1

Chapter IV
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Low Values of B Complex Vitamins

What is low values of B complex vitamins?
Insufficient vitamin B intake for normal functioning of the body. There are actually 8 different types of B vitamins: thiamine (B1), riboflavin (B2), niacin (B3), pyridoxine (B6), folic acid (B9), cyanocobalamin (B12) pantothenic acid and biotin (B7). A vitamin B deficiency can involve any one of these types or a combination. As Vitamin B plays a role in many aspects of the body's functioning, deficiency can have a serious impact on overall health

Are there different types of low values of B complex vitamins?

Vitamin B1 is essential for the body to be able to use carbohydrate as an energy source as well as for metabolising amino acids. lack of sufficient thiamine in the diet can cause loss of appetite, poor digestion, chronic constipation, loss of weight, mental depression, nervous exhaustion, and insomnia. Vitamin B1 deficiency is usually connected to alcoholism, malabsorption diseases, and poor diet.

Vitamin B2 is needed to process amino acids and fats, activate vitamin B6 and folic acid, and help convert carbohydrates into the fuel the body runs on adenosine triphosphate (ATP). A deficiency of vitamin B2 (riboflavin) may result in bloodshot eyes, abnormal sensitivity to light, itching and burning of the eyes, inflammation in the mouth, a sore and burning tongue, and cracks on the lips and in the corners of the mouth. Vitamin B3 (Niacin) works closely with vitamin B1, vitamin B2, vitamin B6, pantothenic acid, and biotin to break the carbohydrates, fats, and proteins in food down into energy. A niacin deficiency often leads to a chronic illness called pellagra, characterized by gastrointestinal problems, lesions of the skin, and dementia. Vitamin B3 deficiency can occur in alcoholics, individuals with poor or irregular diets, and in 13

individuals with medical conditions causing malabsorption from the intestinal tract. Vitamin B5 (pantothenic acid) is essential for human growth, reproduction and many normal bodily processes. Many foods contain vitamin B5, therefore a deficiency of this nutrient is rare. Vitamin B5 deficiency causes depression, personality changes, heart problems, increased risk of infections, fatigue, abdominal pains, sleep disturbances, numbness and altered sensation in the arms and legs, muscle weakness, cramps, increased sensitivity to insulin.

Vitamin B6 (pyridoxine) supports more vital bodily functions than any other vitamin. Vitamin B6 deficiency is one of the most common nutritional deficiencies. Vitamin B6 deficiency can cause impaired immunity, skin lesions, and mental confusion. A marginal deficiency sometimes occurs in alcoholics, patients with kidney failure, and women using oral contraceptives. Some of these symptoms can also result from a variety of medical conditions other than vitamin B6 deficiency.

Biotin (vitamin B7) helps in the synthesis of fatty acids, in energy metabolism, and in the synthesis of amino acids and glucose. Biotin deficiency results in fatigue, depression, nausea, muscle pains, hair loss, and anemia. Symptoms of a biotin deficiency include hair loss, a dry, scaly rash around the eyes, nose, mouth, and genital area, decreased appetite, nausea and vomiting and failure to thrive in children. Folic acid (vitamin B9) is important for any stage of human life which involves growth such as pregnancy, lactation and early growth. Folic acid deficiency causes mood disorders and low levels may play a role in depression, possibly due to a reduction in neurotransmitter levels. Folic acid deficiency during pregnancy increases the risk for neural tube defects including cleft palate, spina bifida, and brain damage. Vitamin B12 (cyanocobalamin, cobalamin) is considered the most potent vitamin and is one of the last true vitamins that has been classified. Vitamin B12 is essential for normal nervous system function and blood cell production. Vitamin B12 deficiency occurs when there is an abnormally low level of vitamin B12 absorbed in the body. Vitamin B12 deficiency results in impairment of the activities of B12-requiring enzymes.

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What causes low values of B complex vitamins in the body?

MAJOR CAUSES Vitamin B complex comprises a number of vitamins that exist as a family. They should not be taken individually. In this modern era, millions of people suffer from a deficiency of vitamin B for several reasons, chief among which are:

Stress: emotional, physical and spiritual Processed foods in the diet: these are not real foods and so they tax the body Refined sugar. The average person consumes at least 140 pounds of sugar a year which robs the body of its vitamin B stores Drugs: both recreational and prescription drugs deplete vitamin B Toxins: poisons in the environment and personal care products deplete vitamin B complex Malnutrition. Most people are malnourished because they are not eating the right kinds of foods Cooking. Most people do not eat enough real, raw foods, so vitamin B is killed or so depleted that people are not getting enough of it in the diet

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What are the symptoms?

Thiamin (vitamin B1): loss of appetite, poor digestion, chronic constipation, muscular weakness, leg cramps. Vitamin B2: sore throat, seborrheic dermatitis, premature wrinkles.

Vitamin B3 (Niacin): indigestion, fatigue, canker sores, vomiting, dementia. Vitamin B5 (pantothenic acid): fatigue, insomnia, depression, vomiting, stomach pains, burning feet. Vitamin B6 (pyridoxine): dermatitis, cracked and sore lips, inflamed tongue and mouth, neuropathy. Folic acid: diarrhea, loss of appetite, weight loss, weakness, sore tongue, headaches, heart palpitations. Vitamin B12 (cobalamin): burning of the tongue, fatigue, weakness, loss of appetite, constipation and diarrhea, abdominal pain, weight loss.

How is it treated?
There are a number of things you can do to prevent and overcome vitamin B complex deficiency: 1. Stop eating refined sugar. 2. Stop eating artificial ingredients. Read all labels on your foods and if there are names of chemicals, dont eat them. 3. Reduce stress through a regular exercise program, meditation, counseling and/or hobbies 4. Stop drinking coffee; switch to organic decaffeinated coffee or organic green tea 5. Eat more vitamin B-containing foods oats, barley, wheat bran, avocado, salmon, Brazil nuts and others.

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6. Be patient. It took a while to create a vitamin B deficiency, so it takes a while to reverse the problem; with severe cases it can take a year or so, with milder cases it can take just a few days. 7. If you have a friend or relative with a mental or emotional disorder, think of the possibility of a vitamin B complex deficiency and then make suggestions for adjustments in their diet and take appropriate whole food formulas. 8. Always coordinate all of your health and treatment plans with all of your practitioners. 9. Avoid toxins in your life. This is a serious issue that causes more health problems than_people_commonly_realize.

World's Healthiest Foods ranked as quality sources of: vitamin B6 (pyridoxine) World's Serving Amount DV Nutrient Healthiest Size Cals (mg) (%) Density Foods Rating 1 cup 1 cup 1 cup 145 g 41.4 24.8 28.8 49.3 0.44 0.23 0.26 0.42 0.35 1.18 0.21 0.08 0.14 22.0 11.5 13.0 21.0 17.5 59.0 10.5 4.0 7.0 9.6 8.3 8.1 7.7 7.5 6.7 6.6 6.4 6.0 excellent excellent excellent excellent very good very good very good good very good

Food Spinach, boiled Bell peppers, red, raw, slices Turnip greens, cooked Shiitake Mushrooms, raw Garlic Cauliflower, boiled Cayenne pepper, dried Mustard greens, boiled

1 oz-wt 42.2 1 cup 2 tsp 1 cup 28.5 11.2 21.0

Tuna, yellowfin, baked/broiled 4 oz-wt 157.6

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Banana Celery, raw Cabbage, shredded, boiled Crimini mushrooms, raw Asparagus, boiled Broccoli, steamed Turmeric, powder Kale, boiled Collard greens, boiled Brussel sprouts, boiled Watermelon, diced Leeks, boiled Tomato, ripe Snapper, baked/broiled Carrots, raw Eggplant, cooked, cubes Cantaloupe, cubes Romaine lettuce Potato, baked, with skin Onions, raw Blackstrap molasses Calf's liver, braised Chicken breast, roasted Ginger root Venison Beef tenderloin, lean, broiled Flaxseeds Winter squash, baked, cubes Strawberries Avocado, slices Pineapple Grapes World's Healthiest Foods Rating

1 each 108.6 1 cup 1 cup 1 cup 1 cup 2 tsp 1 cup 1 cup 1 cup 1 cup 1 cup 1 cup 1 cup 1 cup 2 cup 1 cup 2 tsp 19.2 33.0 43.2 43.7 16.0 36.4 49.4 60.8 48.6 37.8 52.5 27.7 56.0 15.7 60.8 32.1

0.68 0.10 0.17 0.16 0.22 0.22 0.08 0.18 0.24 0.28 0.22 0.06 0.14 0.52 0.18 0.09 0.18 0.05 0.42 0.19 0.10 0.56 0.64 0.05 0.43 0.49 0.18 0.15 0.08 0.41 0.13 0.10

34.0 5.0 8.5 8.0 11.0 11.0 4.0 9.0 12.0 14.0 11.0 3.0 7.0 26.0 9.0 4.5 9.0 2.5 21.0 9.5 5.0 28.0 32.0 2.5 21.5 24.5 9.0 7.5 4.0 20.5 6.5 5.0

5.6 4.7 4.6 4.6 4.6 4.5 4.5 4.5 4.4 4.1 4.1 3.3 3.3 3.2 3.1 2.9 2.9 2.9 2.8 2.8 2.8 2.7 2.6 2.3 2.2 1.8 1.7 1.7 1.7 1.6 1.5 1.5

very good very good very good very good very good very good Good very good very good very good very good Good Good Good Good Good Good Good Good Good Good Good Good Good Good Good Good Good Good Good Good Good

5 oz-wt 31.2

0.5 cup 16.1 4 oz-wt 145.2

1 cup 133.0

4 oz-wt 187.1 4 oz-wt 223.4 1 oz-wt 19.6 4 oz-wt 179.2 4 oz-wt 240.4 2 tbs 1 cup 1 cup 1 cup 1 cup 95.3 80.0 43.2 76.0 61.6

1 cup 235.1

Rule

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excellent very good good

DV>=75% DV>=50% DV>=25%

OR OR OR

Density>=7.6 Density>=3.4 Density>=1.5

AND AND AND

DV>=10% DV>=5% DV>=2.5%

Chapter V The Correlation between Low Values of B Complex Vitamins and Seborrheic Dermatitis

There are many other factors that may be helpful in controlling this condition. Medical research has shown a correlation between seborrheic dermatitis and low values of B complex vitamins. There may also be a relationship between the condition and a low intake of high quality essential fatty acids. The body cannot manufacture omega 3, 6 and 9 fatty acids. They must be obtained from food sources or supplemented. Conversely, we as a society eat far too many trans fats and poor quality fatty acids in our daily diet of supermarket, restaurant and junk foods. Changing the balance between these two types of fats in the diet may be helpful to control seborrheic dermatitis. Deficiencies of Vitamin B2 can cause ariboflavinosis, which will have symptoms of cracked lips, inflammation of the tongue, sensitivity to sunlight, seborrheic dermatitis, pseudo-syphilis affecting the mouth and scrotum. Since vitamin B6 is integral to the process of new cell formation, it plays a key role in the healthy function of body tissue, such as skin, which regenerates quickly. As such, symptoms of deficiency often first manifest in skin conditions. Eczema, seborrheic dermatitis and other skin disorders have been associated with vitamin B6 deficiency. To this day, topical B6 creams are used in the treatment of dermatitis, notably for symptoms related to seborrheic dermatitis. Biotin (B7), one of the B complex vitamins found in organ meats (e.g., liver, heart, kidney), egg yolk, cauliflower, chocolate, and mushrooms. Its synthesis by intestinal bacteria makes human deficiency states rare, unless the diet contains significant raw egg white protein (avidin), which complexes the vitamin to prevent intestinal absorption. Dermatitis, retarded growth, and loss of hair and muscular

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control occur in experimental animals with deficiency. Biotin functions as a coenzyme for carboxylase enzymes that catalyze fixation of carbon dioxide (e.g., in fatty acid synthesis).

Conclusion
Seborrheic dermatitis is a chronic inflammatory disease that affects scalp and bodies with sebaceous gland, which based on constitutional factors such seborrheic status. Seborrheic dermatitis can be caused by many factors, such as hormonal, fungal infection, lack of nutrition (especially B complex vitamins; B2(riboflavin), B6(pyridoxine), B7(biotin)), neurogenic factor, genetic factor and environment. According to the lesion area,seborrheic dermatitis is divided into 3: a. Scalp seborrheic b. Face seborrheic c. Body and folds seborrheic The effective treatments for seborrheic dermatitis are anti inflamation and anti fungal drugs. In this case, patient should be told that his/her disease is chronic and often relapse. Avoid triggers, such as emotional stress, fatty foods, etc. Because based on constitutional factor and recurrency, so the prognosis of seborrheic dermatitis is quite difficult to cure even with controlled treatment.

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References

1. Harahap Mawarli. Ekzema dan Dermatitis: Dermatitis Seboroik. In: Ilmu Penyakit Kulit. Jakarta : Hipokrates, 2000 : 14-16. 2. Marks James G Jr, Miller Jeffrey. J Lookingbill and Marks Principles of Dermatology. 4th ed., Saunders Elsevier, 2006 : 111-112. 3. Usatine RP. Papulosquamous conditions. In : The Color Atlas of Family Medicine. China : Mc Graw-Hill Companies, 2009 : 615-619. 4. Robin GB, Tony B. Lecture Notes Dermatology. 8th ed., Jakarta : Erlangga Medical Series, 2005 : 74-75. 5. Handoko RP. Dermatosis Eritroskuamosas. In : Djuanda Adhi, Mochtar H, Siti A, eds. Ilmu Penyakit Kulit dan Kelamin. 5th ed. Cetakan I, Jakarta : Penerbit Fakultas Kedokteran Universitas Indonesia, 2007 : 200-202. 6. Weller PJB, dkk. Eczema and dermatitis : Seborrheic eczema. In : Clinical Dermatology. 4th ed., Oxford : Blackwell Publishing, 2008 : 97-99. 7. Schwartz, Robert A.; Janusz, Christopher A.; Janniger, Camila K. (July 2006). "Seborrheic dermatitis: an overview". American Family Physician 74 (1): 12530.

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