Vitamin D levels in patients with seborrheic dermatitis

SUMMARY OBJECTIVE: Seborrheic dermatitis is a common papulosquamous skin disease with unknown pathogenesis. The aim of our study was to determine the serum level of 25-hydroxy vitamin D in patients with seborrheic dermatitis SD. METHODS: A total of 53 patients and 60 healthy controls were included in the study. Serum vitamin D, calcium, phosphorus, and parathormone levels were measured in the patient and control groups, and a comparison was made between the two groups regarding these parameters. RESULTS: Severe vitamin D deficiency was more frequent among patients with seborrheic dermatitisSD compared to controls (52.8 vs. 25.8%, p=0.003). In patients with severe vitamin D deficiency, seborrheic dermatitis SD was detected more frequently at an early age (p=0048) and in women (p=0.015). No correlation was found between the seborrheic dermatitis skin involvement site and vitamin D level. CONCLUSION: The fact that vitamin D levels decreased in patients with seborrheic dermatitis SD and patients with severe vitamin D deficiency develop seborrheic dermatitis SD earlier suggests that the low levels of vitamin D are related to seborrheic dermatitis.

Is cutaneous microbiota a player in disease pathogenesis? Comparison of cutaneous microbiota in psoriasis and seborrheic dermatitis with scalp involvement

Background: Knowledge about cutaneous microbiota in psoriasis vulgaris and seborrheic dermatitis is limited, and a comparison of microbiota in the two diseases was not yet previously undertaken. Aims/Objectives: This study aimed to compare the scalp lesional and non-lesional microbiota in psoriasis vulgaris and seborrheic dermatitis with that in a healthy control group. Methods: Fifty samples were taken with sterile swabs from patients’ and controls’ scalps, and 16S rRNA gene sequencing analyses were performed. Results: Alpha and beta diversity analyses showed that bacterial load and diversity were significantly increased in psoriasis vulgaris and seborrheic dermatitis lesions compared to the controls. As phyla, Actinobacteria decreased and Firmicutes increased, while as genera, Propionibacterium decreased; Staphylococcus, Streptococcus, Aquabacterium, Neisseria and Azospirillum increased in lesions of both diseases. Specifically, Mycobacterium, Finegoldia, Haemophilus and Ezakiella increased in psoriasis vulgaris and Enhydrobacter, Micromonospora and Leptotrichia increased in seborrheic dermatitis lesions. Mycobacterium, Ezakiella and Peptoniphilus density were higher in psoriasis vulgaris compared to seborrheic dermatitis lesions. The bacterial diversity and load values of non-lesional scalp in psoriasis vulgaris and seborrheic dermatitis lay between those of lesional areas and controls. Limitations: The small sample size is the main limitation of this study. Conclusion: Higher bacterial diversity was detected in lesions of both psoriasis and seborrheic dermatitis compared to the controls, but similar alterations were observed when the two diseases were compared. Although these differences could be a result rather than a cause of the two diseases, there is a need to analyze all members of the microbiota and microbiota-host interactions

Pigmented transverse nasal band: A review

Pigmented transverse nasal band/groove is an asymptomatic benign condition, characterized by the development of erythematous to hyperpigmented, well-demarcated, transverse groove at the junction of middle and lower two-third of the nasal dorsum. Although the pathogenesis is unclear, embryologic origin seems to be the most plausible hypothesis. This condition is often associated other related dermatological conditions such as milia, comedones, seborrheic dermatitis and atopic dermatitis. Diagnosis is mostly clinical, while reassurance is the mainstay of therapy. In persistent cases, topical retinoids have been used. In this article, we have reviewed the different aspects of this condition including treatment, along with the recent updates to create awareness about this dermatological entity

Seborrheic dermatitis and its relationship with Malassezia spp / Dermatitis seborreica y su relación con Malassezia spp

Abstract Seborrheic dermatitis (SD) is a chronic inflammatory disease that that is difficult to manage and with a high impact on the individual's quality of life. Besides, it is a multifactorial entity that typically occurs as an inflammatory response to Malassezia species, along with specific triggers that contribute to its pathophysiology. Sin ce the primary underlying pathogenic mechanisms include Malassezia proliferation and skin inflammation, the most common treatment includes topical antifungal keratolytics and anti-inflammatory agents. However, the consequences of eliminating the yeast population from the skin, the resistance profiles of Malassezia spp. and the effectivity among different groups of medications are unknown. Thus, in this review, we summarize the current knowledge on the disease´s pathophysio logy and the role of Malassezia sp. on it, as well as, the different antifungal treatment alternatives, including topical and oral treatment in the management of SD.

Resumen La dermatitis seborreica (DS) es una enfermedad inflamatoria crónica, con un elevado impacto en la calidad de vida del individuo. Además, DS es una entidad multifactorial que ocurre como respuesta inflamatoria a las levaduras del género Malassezia spp., junto con factores desencadenantes que contribuyen a la fisio patología de la enfermedad. Dado que el mecanismo patogénico principal involucra la proliferación e inflamación generada por Malassezia spp., el tratamiento más usado son los agentes tópicos antifúngicos y antiinflamatorios. Sin embargo, se desconocen las consecuencias de eliminar la población de levaduras de la piel, los perfiles de resistencia de Malassezia spp. y la efectividad entre grupos diferentes de medicamentos. Por tanto, en esta revisión de la literatura, resumimos el conocimiento actual sobre la fisiopatología de la enfermedad y el papel de Malassezia sp., así como de las diferentes alternativas de tratamiento antifúngico tanto tópico como oral en el manejo de la DS.

Probióticos y prebióticos: beneficios en dermatología / Probiotics and prebiotics: benefits in dermatology

La piel es el órgano más extenso del cuerpo humano, y constituye el límite físico entre el individuo y su entorno; a pesar de tener un sistema inmunológico funcional la piel está colonizada por diversos tipos de microorganismos, en su mayoría benéficos, que en conjunto componen el microbioma cutáneo, el cual juega un papel importante en la homeostasis corporal y su modificación está implicada en diversas patologías, lo que lo ha convertido en una potencial diana terapéutica. Los probióticos y prebióticos se han estudiado en afecciones inflamatorias de la piel como la dermatitis atópica, el acné, la dermatitis seborreica y el cáncer de piel. En esta revisión describimos a la luz de la evidencia actual su eficacia en dermatosis relacionadas con disbiosis cutánea.

The skin is the largest organ in the human body and constitutes the physical boundary between the individual and their environment; despite having a functional immune system, the skin is colonized by various types of microorganisms, mostly beneficial, which together constitute the skin microbiome, which plays an important role in body homeostasis and its modification is involved in various pathologies, which has made it a potential therapeutic target. Probiotics and prebiotics have been studied in inflammatory skin conditions such as atopic dermatitis, acne, seborrheic dermatitis, and skin cancer. In this review we describe its efficacy in dermatoses related to cutaneous dysbiosis in light of current evidence.

Seborrheic dermatitis-distributed dermatomyositis: a special type of dermatomyositis / 中华皮肤科杂志

Seborrheic dermatitis-distributed dermatomyositis, a special type of dermatomyositis, is characterized by facial seborrheic dermatitis-distributed rashes, usually accompanied by Gottron papules, inverse Gottron papules, mechanic′s hands and skin ulcers, seldom accompanied by muscle involvement. Anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive patients with seborrheic dermatitis-distributed dermatomyositis are prone to interstitial lung disease/rapidly progressive interstitial lung disease. Early diagnosis of seborrheic dermatitis-distributed dermatomyositis can be made through the combination of rashes and antibody detection, and early and active combined treatment with glucocorticoids and immunosuppressors can improve the survival rate of patients.

Dermatitis seborreica infantil extensa en un lactante / Extensive infantile seborrhoeic dermatitis in an infant

RESUMEN Introducción: la dermatitis seborreica es una enfermedad inflamatoria cutánea crónica que se caracteriza por la presencia de eritema y descamación de la piel en las zonas afectadas. Es el resultado de la combinación de tres factores: secreción sebácea, presencia de Malassezia y la respuesta inmune; se distinguen dos formas principales: la infantil y la del adulto. Presentación del caso: lactante de tres meses de edad, producto de parto distócico por cesárea a las 39 semanas, gemelar; que asistió a consulta de Dermatología traído por sus padres, quienes refirieron cuadro de 15 días de evolución de lesiones en cuero cabelludo y área del pañal eritematosas. Según la madre el paciente recibe alimentación complementaria y su hermano gemelar presentaba el mismo cuadro, pero de menor intensidad. Se diagnosticó dermatitis seborreica infantil, patrón Costra Láctea y patrón dermatitis seborreica de los pliegues. Se brindó Educación Sanitaria a los padres e indicó tratamiento local a ambos pacientes basado en el lavado frecuente del cuero cabelludo, loción capilar (ácido salicílico 2 % + aceite mineral 100 ml) y cremas esteroidea y antimicótica. Se logró mejoría clínica evidente. Conclusiones: esta enfermedad es una dermatosis frecuente en los lactantes, con un patrón clínico característico cuyo estudio resulta necesario, sobre todo por parte de los médicos de la Atención Primaria de Salud, para garantizar un tratamiento adecuado que evite complicaciones.

ABSTRACT Introduction: seborrhoeic dermatitis is a chronic inflammatory skin disease characterized by the presence of erythema and peeling of the skin in the affected areas. It results from the combination of three factors: sebaceous secretion, presence of Malassezia and the immune response; distinguishing two main forms: the infantile and the adult. Case report: a 3-month-old twin infant, born by dystocic caesarean delivery at 39 weeks. His parents brought him to the dermatology clinic; they reported a 15-day chart of evolution of scalp lesions and diaper erythematous area. The mother stated the patient receives complementary feeding and the twin brother has the same clinical picture, but in less extent. Infantile seborrhoeic dermatitis, milky crust pattern with seborrhoeic dermatitis pattern of the folds were examined and diagnosed. Hygienic education was provided to parents and local treatment is indicated to both patients based on frequent washing of the scalp, hair lotion (2% salicylic acid + 100 ml mineral oil), steroid and antifungal creams, achieving obvious clinical improvement. Conclusions: this entity is a frequent dermatosis in infants, with a clinical characteristic pattern which study is necessary, particularly for Primary Health Care Physicians, to ensure adequate treatment avoiding complications.

Comparison of Two Specimen-Collection and Microscopy Methods for the Rapid Laboratory Diagnosis of Seborrheic Dermatitis- A Pilot Study

Malassezia spp. causes seborrheic dermatitis. For laboratory diagnosis, skin scrapings are collected and mounted in potassium hydroxide (KOH) for microscopy and processed for culture. Obtaining scrapings has disadvantages and KOH lacks colour contrast making interpretation difficult. This pilot study compared the results of specimen collection by cellophane tape method with scraping method. It also compared microscopy using Chicago Sky Blue 6B (CSB) stain plus KOH with the conventional method using KOH alone.METHODSSkin specimens were collected from the affected sites of 80 patients by scraping and cellophane tape. Specimens were subjected to KOH examination, KOH plus CSB stain, and culture for the presence of Malassezia spp.RESULTSA total of 160 specimens were collected from 80 patients for microscopy. Of 160 specimens, each was subjected to KOH and CSB plus KOH, 145 (91%) demonstrated Malassezia spp. by CSB plus KOH and 124 (77.5%) by KOH alone (p= 0.001). Cellophane tape method yielded 141 (88%) positive results compared to 128 (80%) by skin scraping (p=0.047). The odds of detecting Malassezia spp. was 4.4 times greater when the specimen was collected by cellophane tape and subjected to microscopy with CSB and KOH than when it was collected by scraping and examined microscopically with KOH alone (p= 0.002).CONCLUSIONSCellophane tape is a convenient method for specimen collection. CSB stain provides colour contrast and enables easy identification of fungal elements.

Clinical study on treatment of facial seborrheic dermatitis with intense pulsed light combined with 30% supramolecular salicylic acid

OBJECTIVES: In this study, we investigated the effects of intense pulsed light (IPL) combined with 30% supramolecular salicylic acid on facial seborrheic dermatitis. METHODS: A total of 45 patients with mild or moderate facial seborrheic dermatitis were selected from our hospital between September 2018 and September 2019. The patients were divided into three groups consisting of 15 patients each. The first group was exposed to a combination of IPL and 30% supramolecular salicylic acid treatment, the second group was exposed to the IPL treatment alone, and the third group was exposed to the 30% supramolecular salicylic acid treatment alone. They were treated once every 4 weeks in three consecutive rounds. RESULTS: Facial lesions and symptoms were observed 4 and 12 weeks after the first treatment, and adverse reactions were recorded. The combination group showed significant improvement in symptoms 4 weeks after the first treatment, while the individual treatment groups showed no significant improvement. After three rounds of treatments, seborrheic dermatitis had significantly decreased in the three groups; the efficacy of the combined treatment group was significantly higher than that of the IPL group and the 30% supramolecular salicylic acid group. CONCLUSION: IPL combined with 30% supramolecular salicylic acid was effective in the treatment of facial seborrheic dermatitis and provided a quicker result with no adverse reactions.

Ocular surface damage in dry eye patients with seborrheic dermatitis / 中华实验眼科杂志

Objective@#To observe the ocular surface function changes of dry eye patients with seborrheic dermatitis and discuss the significance of seborrheic dermatitis in ocular surface damage.@*Methods@#A cohort study was performed.Forty-nine patients (49 eyes) who were initial diagnosed with dry eye enrolled in General Hospital of Tianjin Medical University from October 2015 to March 2016 were divided into 2 groups, including 21 patients with seborrheic dermatitis and 28 patients without seborrheic dermatitis.Gender, age, meibomian gland dysfunction (MGD), eyelid margin scores, eyelid secretions scores, meibomian gland imaging scores, conjunctival congestion scores, ocular surface disease index (OSDI), Schirmer Ⅰtest (SⅠt), break-up time of tear film (BUT), fluorescent integral score were examined and compared.The study was followed the Declaration of Helsinki and was approved by General Hospital of Tianjin Medical University (No.IRB2015-YX-069). Written informed consent was obtained from all subjects before entering the study.@*Results@#There were not significant differences in gender and ages (χ2=1.536, P=0.215; t=0.642, P=0.524). The rate of MGD in seborrheic dermatitis group was 57.15%, which was significantly higher than that in the non-seborheic dermatitis group (25.00%), with significan difference between the two groups (χ2=5.222, P=0.022). There were significant differences in eyelid margin scores, eyelid secretions scores, meibomian gland imaging scores, fluorescent integral scores between the two groups (Z=2.105, 3.303, 3.368, 3.036, all at P<0.05). The OSDI in the seborheic dermatitis group was 26.43±8.05, which was significantly larger than that in the non-seborheic dermatitis group (16.75±5.74); the BUT in the seborheic dermatitis group was (6.14±1.98)s, which was significantly shorter than that in the non-seborheic (8.75±1.38)s (t=4.918, 5.434; both at P<0.05).@*Conclusions@#Seborrheic dermatitis may aggravate ocular surface dysfunction in dry eye patients.

Ocular surface damage in dry eye patients with seborrheic dermatitis / 中华实验眼科杂志

Objective To observe the ocular surface function changes of dry eye patients with seborrheic dermatitis and discuss the significance of seborrheic dermatitis in ocular surface damage. Methods A cohort study was performed. Forty-nine patients (49 eyes) who were initial diagnosed with dry eye enrolled in General Hospital of Tianjin Medical University from October 2015 to March 2016 were divided into 2 groups,including 21 patients with seborrheic dermatitis and 28 patients without seborrheic dermatitis. Gender, age, meibomian gland dysfunction (MGD), eyelid margin scores, eyelid secretions scores, meibomian gland imaging scores, conjunctival congestion scores,ocular surface disease index ( OSDI) ,Schirmer Ⅰtest ( SⅠt) ,break-up time of tear film ( BUT) ,fluorescent integral score were examined and compared. The study was followed the Declaration of Helsinki and was approved by General Hospital of Tianjin Medical University (No. IRB2015-YX-069). Written informed consent was obtained from all subjects before entering the study. Results There were not significant differences in gender and ages (χ2=1. 536,P=0. 215;t=0. 642,P=0. 524). The rate of MGD in seborrheic dermatitis group was 57. 15％,which was significantly higher than that in the non-seborheic dermatitis group (25. 00％),with significan difference between the two groups (χ2 =5. 222,P=0. 022). There were significant differences in eyelid margin scores,eyelid secretions scores,meibomian gland imaging scores,fluorescent integral scores between the two groups (Z=2. 105,3. 303,3. 368, 3. 036,all at P<0. 05). The OSDI in the seborheic dermatitis group was 26. 43±8. 05,which was significantly larger than that in the non-seborheic dermatitis group (16. 75±5. 74);the BUT in the seborheic dermatitis group was (6. 14± 1. 98)s,which was significantly shorter than that in the non-seborheic (8. 75±1. 38)s (t=4. 918,5. 434;both at P<0. 05). Conclusions Seborrheic dermatitis may aggravate ocular surface dysfunction in dry eye patients.

Dermatitis seborreica como manifestación cutánea de sífilis primaria en paciente con SIDA / Seborrheic dermatitis as a cutaneous manifestation of syphilis in patient a with AIDS

Existe una asociación epidemiológica entre sífilis e infección por VIH; las úlceras genitales favorecen la transmisión de Treponema pallidum y éste a su vez, la transmisión del VIH. La dermatitis seborreica (DS) se presenta en 2 a 4% de la población general; sin embargo, en los pacientes con infección por VIH/SIDA y SIFILIS es significativamente mayor, llegando a 85% en algunas series. Se presenta el caso de un paciente masculino de 22 años de edad, natural y procedente del Distrito Capital, Venezuela, sin otras patologías conocidas, quien acude a la emergencia por presentar periodos de hetero agresividad y desorientación témporo ­ espacial., El familiar refiere aparición de lesiones descamativas de fondo eritematoso en región facial desde hace 6 meses, no pruriginosas y a la exploración física se evidencia parafasia y pupila de Argyll- Robertson. Se reportan serologías Positivas para HIV por ELISA de 4ta Generación, VDRL Reactivo a 4 diluciones y FTA-ABS Reactivo, La punción Lumbar evidenció pleocitosis, hiperproteinorraquia, hipoglucorraquia y VDRL REACTIVO. La biopsia cutánea con coloración argéntica de Fontana fué positiva para Treponema pallidum, con mejoría clínica significativa posterior al cumplimiento del esquema de Penicilina Cristalina. La dermatitis seborreica puede ser uno de los primeros indicadores de infección por VIH, por lo cual en toda dermatitis seborreica atípica, extensa o que no responda a tratamiento debe solicitarse serología para VIH y VDRL(AU)

There is an epidemiological association between syphilis and HIV infection; genital ulcers facilitatethe transmission of Treponema pallidum and this in turn, the transmission of HIV. Seborrheic dermatitis (SD) occurs in 2 to 4% of the general population; however, in patients with HIV / AIDS and SIFILIS infection it is significantly higher, reaching 85% in some series. We present the case of a male patient, of a 22 years-old , natural from the Caracas, Venezuela, without other known pathologies, who came to the emergency ward due to periods of aggressiveness and temporo - spatial disorientation. Desquamative lesions with an erythematous background in in his face appeared 6 months earlier.The neurological examination showeds paraphasia and Argyll-Robertson´ pupil. Positive serologies for HIV by 4th Generation ELISA and VDRL reactive at 4 dilutions as well as positive FTA-ABS were reported, Lumbar tab evidenced pleocytosis, hyperproteinorrachia, hypoglucorraquia and reagent VDRL . The skin biopsy with Fontana silver coloration was positive for Treponema pallidum and he improved clinically after treatment with a Crystalline Penicillin scheme. Seborrheic dermatitis may be one of the first indicators of HIV infection, so in all atypical seborrheic dermatitis, extensive or unresponsive to treatment, serology for HIV and VDRL should be determined(AU)

Clinical Observation of Recipe for Clearing Heat and Removing Dampness Combined with Butyl Flufenamate Ointment in Treating Facial Seborrheic Dermatitis / 广州中医药大学学报

Objective To observe the clinical efficacy of Recipe for Clearing Heat and Removing Dampness combined with Butyl Flufenamate Ointment for the treatment of facial seborrheic dermatitis. Methods A total of 92 patients with facial seborrheic dermatitis were randomly divided into treatment group and control group,46 cases in each group. The treatment group was treated with oral use of Recipe for Clearing Heat and Removing Dampness combined with external use of Butyl Flufenamate Ointment, and the control group was only treated with external use of Butyl Flufenamate Ointment. The treatment for the two groups covered 4 weeks. Before treatment and on treatment day 7, 14 and 28, scores of clinical symptoms, related skin barrier function indexes,and the serum level of cathepsin S(Cat S)in the two groups were observed. Results(1)On treatment day 14,28,the total effective rate in the treatment group was 84.8％, 89.1％,and that in the control group was 65.2％,71.7％ respectively,the difference being significant(P < 0.05).(2)On treatment day 7,14,28, the scores of clinical symptoms in the two groups were obviously decreased(P < 0.05 compared with those before treatment),and the decrease in the treatment group was superior to that in the control group (P < 0.05).(3) On treatment day 7,14,28,facial sebum secretin,skin water content,and transepidermal water loss(TEWL) of the treatment group were improved to various degrees compared with those of the control group,the differences being significnat(P < 0.05 or P < 0.01).(4)On treatment day 28,serum Cat S of the two groups was markedly decreased(P < 0.01 compared with that before treatment),and the decrease in the treatment group was superior to that in the control group (P < 0.01). Conclusion Recipe for Clearing Heat and Removing Dampness combined with Butyl Flufenamate Ointment exerts certain effect for the treatment of facial seborrheic dermatitis.

Personality traits and common psychiatric conditions in patients with seborrheic dermatitis

Abstract Background Seborrheic dermatitis is a skin disease in which psychological factors play a central role in its onset, exacerbation and remission. Objective The aim of this study was to investigate personality traits and common psychiatric conditions in patients with SD. Methods Outpatients who were admitted to the Bozok School of Medicine Department of Dermatology complaining of SD and who volunteered for study were included. Symptom Checklist 90 – Revised (SCL-90-R) and Eysenck Personality Questionnaire – Revised Short Form (EPQ-RSF) were administered before treatment to 50 patients who fulfilled the criteria for inclusion in the study. Results compiled from the 50 subjects were compared to a control group that was comprised of 50 healthy volunteers. Results Of the 50 patients that were included in the study, 25 were female and 25 were male. The Global Symptom Index (GSI; Z = -6.96, P < 0.001), Somatization (Z = -6.59, P < 0.001), Depression (Z = -7.11, P < 0.001), and Anxiety (Z = -6.64, P < 0.001) subscales of the SCL-90-R were evaluated. Statistically significantly higher scores were obtained from patients with SD in comparison with the control group on all of these subscales. In addition, the EPQ-RSF Neuroticism subscale was statistically significantly higher (Z = -4.99, P < 0.001) in patients with SD. Discussion Our results showed that common psychiatric conditions are considerably frequent in SD patients. More importantly, neurotic personality characteristics were much more frequent in these patients. These findings suggest SD to be a psychosomatic disorder that requires a multi-disciplinary approach.

Study of cutaneous manifestations in HIV infection

Background: HIV infection is associated with numerous cutaneous changes even before the onset of immunologic dysfunction and AIDS. We all know that as search for reliable clinical indicators for management of human immunodeficiency syndrome in resource poor settings continues, cutaneous disorder can be a good clinical marker of HIV infection, underlying immune status and the disease progression. Aim and objectives: To study occurrence of various cutaneous manifestations in a patients infected with HIV. Materials and methods: 120 HIV positive patients above 14 year old with definite cutaneous manifestations attending dermatology OPD in Department of Skin, STD and Leprosy, in a tertiary care centre Dehradun were studied from December 2013 to January 2016. Results: Among 120 HIV positive patients in our cross-sectional study highest number of patients belonged to 31-40 years age group. Male to female ratio was 1.9: 1 and heterosexual route was the most common route of transmission. Among all cutaneous manifestations pruritic papular eruption, cutaneous drug reactions, molluscum contagiosum, seborrheic dermatitis were common. 14.17% had more than one cutaneous disorder and they had advanced stage of the disease. Conclusion: Early recognition of the cutaneous manifestation can help in better management of HIV infection in resource poor setting as it can indicate progression of the disease and underlying immune status

Tinea Capitis Caused by Microsporum canis Misdiagnosed as Seborrheic Dermatitis in a 79-Year-Old Woman / 대한의진균학회지

Microspoum canis is a zoophilic dermatophyte that is often transmitted to humans from cats and dogs. It has become one of the most important causative agents in tinea capitis ane kerion celsi. Tinea capitis is uncommon in an adult. Moreover, tinea capitis caused by Microspoum canis is rare in an elderly. The location of the lesion and the clinical course of tinea capitis might have led physicians into misdiagnosis as the seborrheic dermatitis. Therefore, we report this case to emphasize the importance of KOH mount and fungal culture of the skin lesions mimicking seborrheic dermatitis. We report a case of tinea capitis caused by Microspoum canis in a 79-year-old woman. The lesions were manifested by fine scaly erythematous patches on the fronto-vertex scalp for 2 weeks. She was diagnosed as seborrheic dermatitis in local clinic and was treated with topical steroid. However, the lesion was not improved. She kept a cat as a pet. Culture from biopsy specimen on Sabouraud's dextrose agar showed typical cottony colonies of Microspoum canis. The nucleotide sequence of internal transcribed spacer for clinical isolate was identical to that of Arthroderma otae strain ATCC 23828 (GenBank accession number AY213657). She was treated with 200 mg of oral itraconazole daily for 12 weeks. The skin lesions improved after treatment, and recurrence has not been observed.

In Vitro Anti-Malassezia Activity of Castanea crenata Shell and Oil-Soluble Glycyrrhiza Extracts

BACKGROUND: A new shampoo with anti-Malassezia properties obtained from various plants is required to provide seborrheic dermatitis patients with a wider range of treatment options. OBJECTIVE: The aim of this study was to obtain in vitro susceptibility profiles of Malassezia restricta and M. globosa, the most important pathogenic organisms in the development of seborrheic dermatitis, to the plant extracts used in commercial anti-dandruff shampoos. METHODS: Minimal inhibitory concentrations (MICs) were determined for eight candidate plant extracts and two plant-derived natural products diluted with Leeming and Notman medium to final concentrations of 0.016 to 1 mg/ml. RESULTS: Castanea crenata shell, Camellia sinensis leaf, and oil-soluble Glycyrrhiza extracts presented relatively low MIC values (≤0.5 mg/ml) against both strains. The C. crenata shell and oil-soluble Glycyrrhiza extracts demonstrated especially high anti-Malassezia activity, suggesting their potential use in the treatment of seborrheic dermatitis. The extracts also showed fungistatic activity against other common facultative pathogenic yeasts, Cryptococcus and Candida. CONCLUSION: C. crenata shell and oil-soluble Glycyrrhiza extracts could potentially be used as active ingredients in anti-seborrheic and anti-dandruff shampoo formulations. They could be helpful for repeated treatments and regular prophylaxis of scalp seborrheic dermatitis.

Seborrheic dermatitis treatment with stellate ganglion block: a case report / 대한마취과학회지

Seborrheic dermatitis is a chronic recurrent inflammatory disorder presumed to be caused by increased sebaceous gland secretion, metabolic changes in the cutaneous microflora, and changes in the host immune function. Stellate ganglion block (SGB) is known to increase the blood flow rate without altering the blood pressure, heart rate, or cardiac output, to stabilize hypertonic conditions of the sympathetic nerves, and to affect the endocrine and immune systems. It is used in the differential diagnosis and treatment of autonomic nervous system disorders of the head, neck, and upper limbs. The authors report the first case of successful treatment of a patient with seborrheic dermatitis through repeated SGB trials.

Efficacy and Safety of Cream Containing Climbazole/Piroctone Olamine for Facial Seborrheic Dermatitis: A Single-Center, Open-Label Split-Face Clinical Study

BACKGROUND: Seborrheic dermatitis (SD) is a multifactorial disease; Malassezia species play an important role in its pathogenesis. OBJECTIVE: We aimed to determine whether a cream containing climbazole/piroctone olamine (C/P cream), antifungal agents with expected efficacy against Malassezia species, could improve SD symptoms. METHODS: We instructed 24 patients with mild-to-moderate SD to apply the C/P cream and emollient cream on the right and left sides of the face, respectively, every morning and evening for 4 weeks. The casual sebum level (measured with Sebumeter®; Courage & Khazaka Electronic GmbH, Germany) and the extent of erythema (measured with Mexameter®; Courage & Khazaka Electronic GmbH) on the face were measured at baseline and after 4 weeks. The minimal inhibitory concentration (MIC) was determined to demonstrate the antifungal activity of the C/P cream. RESULTS: The casual sebum level and erythema were measured at week 4, and the median values demonstrated a quantitative improvement on the C/P cream-treated right side of the face compared to the emollient cream-treated left side. For the C/P cream, the MICs were 0.625, 5, 0.625, and 2.5 mg/ml for Malassezia restricta, M. globosa, M. sympodialis, and M. slooffiae, respectively. CONCLUSION: Based on the reduced casual sebum level and extent of erythema, the antifungal activity of C/P cream against Malassezia species seems useful for the treatment of mild to moderate SD.

Histopathological Differential Diagnosis of Psoriasis and Seborrheic Dermatitis of the Scalp

BACKGROUND: The differential diagnosis of psoriasis and seborrheic dermatitis can be difficult when both conditions are localized to the scalp without the involvement of other skin sites. OBJECTIVE: We aimed to evaluate the histopathological differences between psoriasis and seborrheic dermatitis on the scalp and identify favorable criteria for their differential diagnosis. METHODS: We evaluated 15 cases of psoriasis and 20 cases of seborrheic dermatitis of the scalp that had been clinicopathologically diagnosed. Skin biopsy sections stained with H&E were examined. Additional immunohistochemistry was performed, including Ki-67, keratin 10, caspase-5, and GLUT-1. RESULTS: On histopathological examination, mounds of parakeratosis with neutrophils, spongiform micropustules of Kogoj, and clubbed and evenly elongated rete ridges were significantly more frequently observed in psoriasis. Follicular plugging, shoulder parakeratosis and prominent lymphocytic exocytosis were significantly more common in seborrheic dermatitis. Moreover, significantly higher mitotic figures were observed in psoriatic lesions than in seborrheic dermatitis. Immunohistochemistry did not show any difference between psoriasis and seborrheic dermatitis. CONCLUSION: Histopathological features favoring psoriasis include mounds of parakeratosis with neutrophils, spongiform micropustules of Kogoj, clubbed and evenly elongated rete ridges, and increased mitotic figures (≥6/high-powered field). Features indicating seborrheic dermatitis are follicular plugging, shoulder parakeratosis and prominent lymphocytic exocytosis. Immunohistochemistry was not helpful in differentiating psoriasis from seborrheic dermatitis.