Seborrheic dermatitis associated with HIV infection: new concepts and hypotheses

Abstract

The review article summarizes information about seborrheic dermatitis associated with HIV infection. The article presents current literature data about etiology and pathogenesis of seborrheic dermatitis, as well as the features of the clinical manifestations of seborrheic dermatitis associated with HIV infection. This article contains new hypotheses and concepts about combination of these two diseases. The most important role in pathogenesis of seborrheic dermatitis is belong to the fungus Malassazeia , which uses lipids from the skin surface to produce unsaturated and saturated fatty acids. These fatty acids, being left in the individual’s skin, may induce an inflammatory response. At the same time, the total lipid concentration on the skin surface of HIV-positive and HIV-negative patients with seborrheic dermatitis was similar. However, it was reported about significant alterations in the lipid fractions of HIV-positive patients including a reduction in squalene and an increase in cholesterol and in cholesterol esters, which lead to hypercolonization of the skin with yeast-like fungi and their transition in the pathogenic micellar form. The authors present a clinical case, which is demonstrating a severe course of seborrheic dermatitis associated with HIV infection.