Seborrheic dermatitis manifests as flaking, scaling, inflammation and pruritus primarily on the scalp, but it can also affect the face, retroauricular area and the upper chest. While it affects as many as 42% of babies—commonly called “cradle cap”—its incidence in adulthood is 1% to 3%.1 Optometrists should keep an eye out for this patient population, as new research suggests seborrheic dermatitis may influence meibomian gland morphology and, as a result, cause meibomian gland dysfunction (MGD) and dry eye disease (DED).2
A prospective study, recently published in Contact Lens Anterior Eye, evaluated 50 seborrheic dermatitis patients (Group 1) and 50 healthy individuals (Group 2). All subjects underwent a comprehensive ophthalmic exam that included lid margin alterations, meibomian gland obstruction assessment, Ocular Surface Disease Index assessment, tear film break-up time test, corneal and conjunctival fluorescein staining assessment and Schirmer’s test. In addition, each patient’s upper and lower lids were evaluated for meibomian gland loss with non-contact meibography. The meibomian glands were graded from grade 0 (no loss of meibomian glands) to grade 3 (gland loss >2/3 of the total meibomian glands).
The team discovered that meibomian gland loss, upper meiboscore, lower meiboscore and DED were significantly worse in Group 2 compared with Group 2. They add that there was a significant relationship between age and meibomian gland loss, MGD and DED.
These results led the researchers to recommend that patients with seborrheic dermatitis be evaluated for MGD and DED and start treatment when needed.
1. Borda LJ, Wikramanayake TC. Seborrheic dermatitis and dandruff: a comprehensive review. J Clin Investig Dermatol. 2015;3(2).
2. Yasar E, Kemeriz F, Gurlevik U. Evaluation of dry eye disease and meibomian gland dysfunction with meibography in seborrheic dermatitis. Cont Lens Anterior Eye. March 25, 2019. [Epub ahead of print].