1. Hair-bearing areas: scalp, axillae, eyebrows in both men and women, beard, and presternal area in men (see Fig. 6).

2. Creases and folds: nasolabial folds, perialar creases, glabellar creases, postauricular creases, intertriginous creases in both men and women, and inframammary creases in women (see Fig. 6).

3. Pinna, concha, and the outer third of the external auditory canal.

4. Eyelid margins.

5. Upper back, shoulders, and chest, usually in the form of large patches, or may be confluent over the whole region in men (see Fig. 6).

6. Generalized erythrodermic form (rare).

Involvement of the scalp alone, or combined scalp, ear, and facial SD, are the most common patterns. Eyelid and ear canal involvement is infrequent but not rare. Patch lesions over the upper trunk may simulate pityriasis rosea or pityriasis (tinea) versicolor. These distributions are distinctly uncommon. Confluent activity on the face or upper torso may be very difficult to distinguish from atopic dermatitis. Erythrodermic SD is fortunately very rare and must be separated from other causes of erythroderma.


Petaloid (shaped like petals on a plant) configuration is seen when SD occurs on the central and lateral chest (see Photo 17).

Follicular lesions may be seen with early activity on the scalp, brows, and shoulders. These may also be noted at the periphery of large truncal patches.

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