Paving a path for standardized diagnosis: A systematic review and analysis of seborrheic dermatitis diagnostic criteria

Summary: Abstract Body: Seborrheic dermatitis (SD) is a chronic inflammatory skin condition that is diagnosed clinically, but there is currently no widely accepted, standardized diagnostic criteria. We performed a systematic review to summarize SD diagnostic criteria across published clinical studies to identify common diagnostic approaches and highlight clinical gaps. A systematic search was conducted in Embase, PubMed, Scopus, CINAHL, and Cochrane databases in June 2024 in accordance with PRISMA guidelines. Original investigations with clinical diagnosis of SD were included after deduplication and screening. Data was extracted and analyzed with descriptive statistics, and quality was assessed with JBI critical appraisal tools. From 5548 deduplicated articles, 209 were included for final analysis (>36,000 SD patients). Among all studies, only 22.0% mentioned the use of any clinical criteria to diagnose SD. Skin examination was described in most of these articles, while dermoscopy and trichoscopy were rarely or never described, respectively. Biopsy was used to aid diagnosis / exclude other entities in 10.5%. Only 7.7% of studies (n=16) explicitly described specific SD diagnostic criteria for SD, with general features of erythema (16), scale (15), and location (14) most frequently mentioned, and symptoms like pruritus infrequently mentioned (3). Among clinical trials (n=122), only 5.7% (7) specified diagnostic criteria for inclusion, most with similar reliance on the erythema, scale, and location. In summary, most SD clinical studies including clinical trials did not specify any diagnostic criteria. Of the small number of articles that provided specific clinical criteria, only a few physical signs (and not symptoms) were consistently described. These results suggest near universal lack of standardization in the approach to SD diagnosis. Future research should focus on development of consensus, uniformly applied diagnostic criteria in clinical studies. Carmen Li¹, Jiaqi Chen¹, Christy Chang², Meredith Polaskey¹, Raj Chovatiya¹ 1. Rosalind Franklin University of Medicine and Science Chicago Medical School, North Chicago, IL, United States. 2. University of Illinois Chicago College of Medicine, Chicago, IL, United States. Clinical Research: Epidemiology and Observational Research