Severity Of Seborrheic Dermatitis Research Articles

Nutrition, Obesity, and Seborrheic Dermatitis: Systematic Review.

Pathogenesis of seborrheic dermatitis involves lipid secretion by sebaceous glands, Malassezia colonization, and an inflammatory response with skin barrier disruption. Each of these pathways could be modulated by diet, obesity, and nutritional supplements. Current treatment options provide only temporary control of the condition; thus, it is essential to recognize modifiable lifestyle factors that may play a role in determining disease severity. This study aimed to summarize published evidence on diet, nutritional supplements, alcohol, obesity, and micronutrients in patients with seborrheic dermatitis and to provide useful insights into areas of further research. A literature search of Scopus, PubMed, and MEDLINE (Ovid interface) for English language papers published between 1993 and 2023 was conducted on April 16, 2023. Case-control studies, cohort studies, and randomized controlled trials with 5 or more subjects conducted on adult participants (>14 years) were included, case reports, case series, and review papers were excluded due to insufficient level of evidence. A total of 13 studies, 8 case-control, 3 cross-sectional, and 2 randomized controlled trials, involving 13,906 patients were included. Seborrheic dermatitis was correlated with significantly increased copper, manganese, iron, calcium, and magnesium concentrations and significantly lower serum zinc and vitamin D and E concentrations. Adherence to the Western diet was associated with a higher risk for seborrheic dermatitis in female patients and an increased consumption of fruit was associated with a lower risk of seborrheic dermatitis in all patients. The prebiotic Triphala improved patient satisfaction and decreased scalp sebum levels over 8 weeks. Most studies find associations between regular alcohol use and seborrheic dermatitis, but the association between BMI and obesity on seborrheic dermatitis severity and prevalence is mixed. This review sheds light on specific promising areas of research that require further study, including the need for interventional studies evaluating serum zinc, vitamin D, and vitamin E supplementation for seborrheic dermatitis. The negative consequences of a Western diet, alcohol use, obesity, and the benefits of fruit consumption are well known; however, to fully understand their specific relationships to seborrheic dermatitis, further cohort or interventional studies are needed. PROSPERO CRD42023417768; https://tinyurl.com/bdcta893.

The power of observational medicine over the epidemiology of seborrheic dermatitis

Observational medicine has solved the etiology of a familial seborrheic dermatitis, an allergy to hapten nicotine and allergen tobacco. Also a targeted treatment with sodium cromoglycate and then with Dead Sea salts shows well the involvement of tissue mast cells at the base of the sebaceous glands. Recently, epidemiological studies show a link of severity of seborrheic dermatitis in tobacco smokers. Also, it can be concluded that observational med

Letter to the editor regarding “Analysis of the epidemiology, coexisting skin diseases, and variables affecting seborrheic dermatitis severity”

Letter to the editor regarding “Analysis of the epidemiology, coexisting skin diseases, and variables affecting seborrheic dermatitis severity”

Seborrheic dermatitis: unique possibilities of vitamin therapy

In practical dermatology, the problem of seborrheic dermatitis is actively considered as the most common pathological condition among the population Objective — to study the clinical effectiveness and safety of the use of the Natubiotin drug in the treatment of patients with seborrheic dermatitis. Materials and methods. 150 patients with seborrheic dermatitis were included in the study. The control group included 50 healthy people of the same age. The severity of seborrheic dermatitis was determined using a scoring scale that included evaluation of the intensity of erythema, swelling, wetting, excoriations, peeling, and fattiness of the skin. The level of anxiety was estimated according to the Spielberger—Khanin self-esteem scale, the level of neuroticism — according to the diagnostic method of L.I. Wasserman. A survey was also conducted using the Beck scale for self-assessment of the severity of depression. Depending on the method of treatment, patients with seborrheic dermatitis were divided into two groups: I (experimental) — 100 patients who received Natubiotin drug in a dose of 5 mg once a day for 3 months; II (control) — 50 patients who underwent standard therapy. Results and discussion. Additional inclusion of Natubiotin drug in the treatment regimen of seborrheic dermatitis ensured the recovery of 100 % patients with localization of the pathological process on the scalp and face. Only 5.3 % of patients with localization of seborrheic dermatitis on the trunk had slight scaling and fattiness of the skin. After the treatment with the inclusion of Natubiotin drug, the indicators of the point assessment of the severity of seborrheic dermatitis in patients of group I were significantly better than in group II that received standard therapy. The assessment of subjective symptoms such as itching and sleep disturbances were also significantly better after using Natubiotin. Vitamin therapy with biotin contributed to a significant reduction of state anxiety, depression and neuroticism in patients. The obtained data indicate the high effectiveness of Natubiotin for the treatment of seborrheic dermatitis. Conclusions. The course of seborrheic dermatitis is accompanied by high personal and state anxiety, increased neuroticism and tendency to depression. Therapy of seborrheic dermatitis with the use of Natubiotin is justified and appropriate, as it provides a quick and long­lasting clinical effect, normalization of the skin condition and improvement of the psychogenic state of patients. The obtained results give reason to recommend the widespread use of Natubiotin drug for the treatment of seborrheic dermatitis.

MALASSEZIA COLONIZATION CORRELATES WITH THE SEVERITY OF SEBORRHEIC DERMATITIS.

The aim: To compare the number of fungi of the genus Malassezia on inflated and healthy areas of the skin and to correlate them with the severity of seborrheic dermatitis. Materials and methods: 168 patients with typical manifestations of seborrheic dermatitis on the scalp and face and 30 healthy individuals were recruited. SD severity was assessed by SEDASI. Samples from lesions on scalp, face and intact chest skin were cultivated and/or stained with methylene blue or cotton and inoculated onto Malassezia Leeming & Notman Agar Modified (MLNA). Results: A statistical difference in colonization intensity between all body zones (Dwass-Steel-Critchlow-Flinger pairwise comparisons p≤0,001). Face zone with lesions of SD patients was two times more colonized with funguses than in the control group (38,5 vs 16,5 p=0,003). The sternal area with no skin lesions was more colonized in the SD group (25,0 vs 9,0 p=0,013). The SEDASI was positively correlated with the amount of CFU on the face (Spearman's rho 0,849; p≤0,001) and trunk (0,714; p≤0,001). Conclusions: Our results demonstrate that inflamed seborrheic areas are more colonized with Malassezia fungi than intact areas. The intensity of Malassezia growth is correlated with the severity of the symptoms of seborrheic dermatitis. The level of colonization may be a potential biomarker to indicate the efficiency of new treatment approaches.

A PROSPECTIVE AND OBSERVATIONAL STUDY TO ANALYZE THE ASSOCIATION OF LIPID PROFILE ABNORMALITY WITH DISEASE SEVERITY IN SEBORRHEIC DERMATITIS PATIENTS

Objective: The aim of the study was to evaluate the association of lipid profile abnormality and eborrheic dermatitis by analyzing the lipid profile; and to evaluate the association of lipid profile abnormality and severity of seborrheic dermatitis. Methods: This prospective and observational study was conducted in the department of dermatology in Dr. D.Y. Patil University and Hospital, School of Medicine, Navi Mumbai. The diagnosed cases of Seborrheic Dermatitis were subjected to lipid profile examination. The demographic and disease profile was then compared among the patients with normal and abnormal lipid profile. Results: A total of 30 seborrheic dermatitis patients were analyzed. Eighteen (60%) of the study participants were males. Serum triglyceride, LDL/ HDL ratio, and cholesterol total/HDL ratio were found to be significantly associated with disease severity. Conclusion: The study suggests a significant role of monitoring serum profile in the patients of seborrheic dermatitis.

Seborrheic dermatitis: the choice of topical treatment tactics, taking into account the characteristics of the skin microbiome

Objective — to study the clinical efficacy and safety of Betasalic, Triacutan and Psoricap drugs in the treatment of patients with seborrheic dermatitis. 
 Materials and methods. The study included 75 patients with seborrheic dermatitis (main group). The control group consisted of 56 healthy individuals of the same age. The severity of seborrheic dermatitis in patients was assessed on a point scale, which included the assessment of the intensity of erythema, edema, oozing lesions, excoriation, scaling, skin oiliness. The study of skin microbiocenosis was carried out by the method of its direct qualitative and quantitative assessment. The level of anxiety was assessed using the Spielberger—Khanin self-assessment scale. Depending on the proposed treatment, patients with seborrheic dermatitis were divided into 2 groups: Group I (experimental group) — 43 patients who received Betasalic for 5 days, Triacutan — for 5 days, Psoricap — for 18 days starting from the 11th day of therapy; Group II (comparison group) — 32 patients who received topical corticosteroids. 
 Results and discussion. The course of seborrheic dermatitis is accompanied by disorders of the skin microbiocenosis with an increase in the number of fungi of Malassezia and Candida genus in the affected areas, which requires appropriate treatment. Patients with seborrheic dermatitis are characterized by the presence of high personal and situational anxiety. The inclusion of Betasalic and Triacutan in the standard therapy of seborrheic dermatitis contributed to the recovery of the majority of patients and a significant improvement in different localizations of the pathological process. In contrast to the experimental subgroup, in the subgroup with standard treatment, these rates were significantly lower. Additional inclusion of Psoricap in the treatment regimen of patients with seborrheic dermatitis led to the recovery of 100 % of patients with the localization of the pathological process on the scalp and face. 
 Conclusions. Complex therapy of seborrheic dermatitis with the use of Betasalic ointment, Triacutan cream or ointment and Psoricap cream is pathogenetically proved, since it provides a quick clinical effect, normalization of skin microbiocenosis.

The interrelation of seborrheic dermatitis with facial skin lesions with metabolic syndrome and diabetes mellitus

BACKGROUND: In recent decades, interest in the role of metabolic syndrome and its impact on dermatological pathology has been steadily increasing. One of the pathogenetic components of the metabolic syndrome is inflammation, and many pro-inflammatory factors play a crucial role in the development of this disease. However, the interrelation between the metabolic syndrome and facial skin lesions in seborrheic dermatitis remains not fully understood.
 AIMS: To identify a possible association of seborrheic dermatitis with the involvement of the skin of the face with metabolic syndrome and diabetes mellitus.
 MATERIAL AND METHODS: The study included 45 patients with seborrheic dermatitis, divided into 3 groups (patients with seborrheic dermatitis, patients with seborrheic dermatitis and metabolic syndrome, and patients with seborrheic dermatitis, metabolic syndrome and diabetes mellitus). The severity of the disease was determined by the lesion area and the seborrheic dermatitis severity index (SEDASI). The metabolic syndrome was diagnosed based on the NCEP ATP III criteria.
 RESULTS: When assessing the severity of seborrheic dermatitis of the face and scalp, it was found that in group 1, a mild degree was observed in all (100%) patients. In group 2, 7 (46.7%) patients had moderate lesion and 8 (53.3%) patients had severe lesion. In group 3, a moderate degree of the disease was observed in 10 (82%) patients and severe in 5 (18%) patients. A positive correlation was found between the indices of metabolic syndrome and the severity of seborrheic dermatitis with facial skin lesions. A significant correlation was shown between the level of triglycerides and the number of anatomical zones involved in the process (r=0.74; p 0.01). In patients of groups 2 and 3, a direct interrelation was established between low levels of HDL, high levels of LDL and the severity of SD of the face (r=0.379; p=0.76), (r=0.321, p=0.037).
 CONCLUSION: The severity of the course and spread of seborrheic dermatitis on the face can serve as a diagnostic marker of metabolic syndrome and diabetes mellitus. An increase in the level of LDL and triglycerides, a decrease in the level of HDL, and insulin resistance are associated with a severe course of seborrheic dermatitis in a person, playing a significant role in the pathogenesis of the disease.

Second-to-fourth digit ratio and seborrheic dermatitis in males: a cross-sectional study

BackgroundSeborrheic dermatitis is a common disease characterized by the erythematous plaques with oily-yellow desquamation. Increased sebaceous gland activity by androgenic hormones has played a role in the etiology of the disease. The second-to-fourth digit (2D:4D) ratio is thought to be a marker of prenatal androgen exposure.ObjectivesTo investigate the association between 2D:4D ratios and seborrheic dermatitis in a male population.MethodsHealthy male controls and patients with seborrheic dermatitis were included in this study. One hundred seborrheic dermatitis patients and 120 healthy controls, aged 17-59, were enrolled. A digital Vernier caliper was used to measure the finger lengths. Seborrheic dermatitis severity was assessed using the Seborrheic Dermatitis Area and Severity Index (SDASI).ResultsThe 2D:4D ratios of the patients (x = 0.977) were significantly lower than those of the controls (x = 1.050) for right hands (t = 6.948; p = 0.000; > 0.05). No similar relationship was found between the 2D:4D ratio for left hands (t = 0.901; p = 0.368; > 0.05). Seborrheic dermatitis severity was negatively correlated with 2D:4D ratios of right hands (r = -0.391; p = 0.000-0.05).Study limitationsOne of the main limitations of this study was the small sample, which got a head of us from acquiring certain findings about the 2D:4D ratio and seborrheic dermatitis. The other limitation is that the patient selection did not reflect the general population, as a single clinic was studied.ConclusionTo the authors' knowledge, this is the first study examining the relationship between 2D:4D ratios and seborrheic dermatitis. The result of this study may indicate a line of investigation and can support the theory of prenatal androgen exposure.

Efficacy and safety of low dose oral isotretinoin in comparison with oral itraconazole in the treatment of seborrheic dermatitis among patients attending Erbil dermatology teaching center in Erbil City

Background and objective: Seborrheic dermatitis is chronic skin disease with exacerbation and remission, many topical and systemic therapies were used, including oral antifungal itraconazole, oral isotretinoin efficacy in the treatment of seborrheic dermatitis less studied. This study aimed to compare the efficacy and safety of low dose oral isotretinoin and oral itraconazole in the treatment of patients with seborrheic dermatitis. Methods: A total of 68 patients with seborrheic dermatitis were participating in a randomized, parallel-group study. One group (n = 31) took 200-mg/day oral itraconazole for one week of the first month, followed by 200 mg for the first two days of the next two months. The second group (n = 37) took oral isotretinoin 20 mg twice weekly for three months. Seborrheic dermatitis area severity index and intensity of itching and burning sensation were calculated before, during three months and one month after treatment. Results: Both drugs significantly reduced the severity of seborrheic dermatitis (P <0.05). When the two groups were compared, patients taking oral isotretinoin showed a significantly greater decrease in seborrheic dermatitis area severity index score than itraconazole group particularly in the second and third months of treatment. Conclusion: Low dose oral isotretinoin is more effective than oral itraconazole in treating seborrhea dermatitis.

Clinical manifestation and associated factors of seborrheic dermatitis in Korea.

Systematic investigations of clinical manifestation and factors associated with the severity of seborrheic dermatitis (SD) have rarely been reported in Asia. We investigated the clinical manifestation and associated factors of SD. Patients were asked to fill a self-questionnaire including symptom severity and aggravating factors. We evaluated objective severity and involved sites of SD. Patients were categorized into three groups; young age group (age <30), middle age group (30≤ age <60), and old age group (age ≥60) and we compared clinical features among them. Among 253 patients included, scalp was the most frequently involved site and the most frequently reported aggravating factor was psychological stress. Different age groups have distinct clinical features and severity. Severity of SD decreased with age and patients in the old age group had less frequent involvement of the lower face. Risk factors of scalp involvement were male gender, disease duration ≥7 years and a history of acne. We investigated associated factors of SD and observed different clinical features between the age groups. We suggest that the adult form of SD can be categorized into three groups; young age SD, middle age SD and old age SD.

Seborrheic dermatitis of the eyelid

Seborrheic (say: seb-uh-ree-uh) dermatitis is a chronic inflammatory skin condition presenting as dry whitish scales or greasy scales. Can involve the scalp, eyebrows, forehead, face, trunk, or skin folds. Dandruff and cradle cap are both forms of seborrheic dermatitis. The severity of seborrheic dermatitis can be lessened by controlling the risk factors and by paying careful attention to skin care. Seborrheic dermatitis of the eyelid margin usually responds to gentle cleaning of the lid margins nightly as needed, with undiluted Johnson and Johnson baby shampoo using a cotton swab. Remove thick scales by applying warm olive or mineral oil and then wash off several hours later with Dawn washing detergent and a soft bristle tooth-brush. For dense scalp scaling, 10% Liquor Carbonic Detergents (LCD) in nivea oil may be used at bedtime, covering the head with a shower cap. This should be done nightly for 1-3 weeks. Once controlled, washing with zinc soaps or selenium lotion with periodic use of steroid cream will help maintain remission. Recently, creams classified as topical immune modulators are being used which suppresses the immune system to treat inflammation. Further, it is thought that sunlight improves seborrheic dermatitis. In some persons, the condition gets better in the summer, especially after outdoor activities.

Comparison the Efficacy of Fluconazole and Terbinafine in Patients with Moderate to Severe Seborrheic Dermatitis

Background. Topical agents can be unpleasant due to long-term therapies in patients with moderate to severe seborrheic dermatitis. Systemic antifungal therapy is another alternative in treatment. Aim. This study was conducted to compare the efficacy of oral fluconazole and terbinafine in the treatment of moderate to severe seborrheic dermatitis. Methods. 64 patients with moderate to severe seborrheic dermatitis (SD) were enrolled in a randomized, parallel-group study. One study group took terbinafine 250 mg daily (n = 32) and the other one fluconazole 300 mg (n = 32) weekly for four weeks. Seborrheic dermatitis area severity index (SDASI) and the intensity of itching were calculated before, at the end of treatment, and two weeks after treatment. Results. Both drugs significantly reduced the severity of seborrheic dermatitis (P < 0.001). Multivariate linear regression revealed that efficacy of terbinafine is more than fluconazole (P < 0.01, 95% CI (0.63–4.7)). Moreover, each index of SD severity reduced 0.9 times after treatment. (P < 0.002, 95% CI (0.8–1.02)). The itching rate significantly diminished (P < 0.001); however, there was no difference between these two drugs statistically. Conclusions. Both systemic antifungal therapies may reduce the severity index of SD. However, terbinafine showed more reduction in the intensity of the disease. In other words, the more the primary intensity of the disease is, the more its reduction will be. This trial is resgistered with 201102205871N1.

The efficacy of 1% metronidazole gel in facial seborrheic dermatitis: A double blind study

Seborrheic dermatitis is a common, chronic inflammatory disease of the skin, characterized by erythematous plaques that are covered with yellow, greasy, scales and may or may not be associated with itching. Although a few studies have suggested use of topical metronidazole for the treatment of seborrheic dermatitis, there is no general consensus about it. To evaluate the efficacy of 1% metronidazole gel and its vehicle alone, in the treatment of seborrheic dermatitis. This was a double-blind, prospective, clinical trial. Fifty six patients with seborrheic dermatitis were randomly allocated to either apply 1% metronidazole gel or placebo to their facial lesions, twice daily for 8 weeks. All the patients were evaluated and scored every 2 weeks for 8 weeks. The results were analyzed statistically. A total of 56 patients entered this study and 53 patients completed the treatment course. There was no significant difference in terms of demographic data and lesions severity score. There were statistically significant differences in the reduction of mean severity scores between the 2 groups at the second, fourth, sixth and eighth weeks of treatment (p<0.05). Metronidazole gel significantly decreased mean of seborrheic dermatitis severity score from the 2nd visit (p<0.001). Metronidazole gel is an effective treatment for facial seborrheic dermatitis.

The frequency of common skin conditions in preschool-aged children in Australia: seborrheic dermatitis and pityriasis capitis (cradle cap).

To determine the prevalence and severity of seborrheic dermatitis and pityriasis capitis in Australian preschool-aged children. A stratified cross-sectional skin survey using cluster sampling of centers throughout Victoria, Australia. The study population included children attending child care centers, preschools, and Maternal and Child Health Centers, with the reference population being Australian children 5 years and younger. Of the 1,634 children in the original sample, 1.116 children aged 11 days to 5 years 11 months were included in the study. Parents completed a questionnaire recording demographic information and personal and family history of skin problems and related diseases. A dermatologist performed a total skin examination, including the diaper area for children younger than 12 months. The age- and sex-specific prevalence rates and site and severity of seborrheic dermatitis and pityriasis capitis were measured. The overall age- and sex-adjusted prevalence of seborrheic dermatitis was 10.0% (95% confidence interval [CI], 8.2%-11.7%): 10.4% (95% CI, 7.8%-12.9%) in boys and 9.5% (95% CI, 7.0%-12.0%) in girls. This was highest in the first 3 months of life, decreasing rapidly by the age of 1 year, after which it slowly decreased over the next 4 years. Most (71.9%) had disease classified as minimal to mild. Pityriasis capitis occurred in 41.7% (95% CI, 38.8%-44.6%) of the 1,116 children examined, with 85.8% categorized as minimal to mild only. Seborrheic dermatitis and pityriasis capitis are common in early childhood. Most children have minimal to mild disease that would require little if any treatment. Education programs directed at those caring for preschool-aged children are needed to provide information on simple preventative measures and treatment, if necessary, that could easily reduce the morbidity associated with these very common conditions.

Correlation of Pityosporum ovale density with clinical severity of seborrheic dermatitis as assessed by a simplified technique

One hundred patients with facial seborrheic dermatitis and 42 control subjects were studied. The number of periodic acid-Schiff-positive Pityosporum ovale yeast cells in skin scrapings per high-power field were counted and designated 1 + to 4+. Our data indicate a correlation between the density of P. ovale and the clinical severity of seborrheic dermatitis, both before and after therapy with a precipitated sulfur/salicylic acid shampoo. The data support the concept that yeast contributes to the pathogenesis of seborrheic dermatitis.

Association of Pityrosporum orbiculare (Malassezia furfur) with seborrheic dermatitis in patients with acquired immunodeficiency syndrome (AIDS)

The possible causative role of the yeastlike fungus Pityrosporum (Malassezia) orbiculare in the pathogenesis of seborrheic dermatitis in patients with and without acquired immunodeficiency syndrome (AIDS) has been discussed but not resolved. Ten patients with AIDS-related seborrheic dermatitis were studied for the presence of Pityrosporum organisms. On the basis of a quantitative correlation between numbers of yeast cells adherent to and extruded from keratinocytes and the clinical severity of seborrheic dermatitis, an association, if not a causative role, for Pityrosporum is strongly suggested in seborrheic dermatitis in patients with AIDS. This association was further strengthened by the marked clinical response to ketoconazole in two patients with a concomitant decrease in the number of Pityrosporum cells per keratinocyte.

Seborrheic dermatitis in patients with acquired immunodeficiency syndrome

Many cutaneous disorders are associated with acquired immunodeficiency syndrome. We prospectively evaluated eighteen patients with acquired immunodeficiency syndrome and twelve patients with the immunodeficiency syndrome-related complex for dermatologic disorders. A high prevalence of seborrheic dermatitis was found in patients with acquired immunodeficiency syndrome--83%, in comparison with 1% to 3% of historic control subjects. Patients with the related complex also had an increased incidence of 42%. Seborrheic dermatitis in this population was often more explosive, inflammatory, and severe than is usually seen in otherwise healthy patients. Severity of seborrheic dermatitis correlated with a poor overall prognosis in our patients. Additionally, seborrheic dermatitis may be one of the most common cutaneous manifestations of acquired immunodeficiency syndrome.