When should I consider referring a patient with seborrhoeic dermatitis to a dermatologist?

You should consider referring a patient with seborrhoeic dermatitis to a dermatologist in several key situations:

• Severity and Extent: Refer if the seborrhoeic dermatitis is severe or widespread ¹. For infants and children, this includes severe, extensive, or recalcitrant disease ¹.
• Diagnostic Uncertainty: Referral is appropriate if there is uncertainty regarding the diagnosis ¹.
• Treatment Failure: Consider referral if the condition fails to respond to routine treatment ¹. This also applies if first-line treatments are ineffective ¹. For infants and children, this includes recalcitrant disease ¹.
• Eyelid Involvement: If simple eyelid hygiene measures have been unsuccessful for eyelid involvement, consider referring the patient to dermatology ¹.
• Suspected Underlying Conditions: Referral is necessary if extensive or severe disease may be associated with immune deficiency, to identify a possible serious underlying cause ¹. Generalized seborrhoeic dermatitis in otherwise healthy children is uncommon and may be associated with immune deficiencies such as HIV ¹.
• Need for Specialist Treatment: Referral is indicated if systemic therapy may be required for widespread or refractory lesions ¹. Additionally, treatment with calcineurin inhibitors should not be initiated in primary care without specialist advice due to possible adverse effects and off-label indication ¹.