ArticlePDF Available

Relationship between diet and seborrheic dermatitis

  • July 2018
DOI:10.7241/ourd.20183.6
Authors:
Funda Tamer at Gazi University
Funda Tamer
Download full-text PDF
Read full-text
Download citation

Abstract

Background: Seborrheic dermatitis is a chronic inflammatory skin disease that affects 1-10% of the general population. Malassezia yeasts, immune response and emotional stress have been implicated in the etiology of seborrheic dermatitis. However, the effect of diet on development of seborrheic dermatitis is still controversial. This study investigates the differences in the frequency of consumption of foods and food groups between patients with seborrheic dermatitis and healthy individuals. Material and Methods: Fifty-one patients with seborrheic dermatitis of the scalp (28 female, 23 male) and 50 healthy individuals within the control group (30 female, 20 male) have been included in this study. The mean age of the patients and control group were 30.6±11.4 years and 32.7±10.7 years, respectively (p=0.35). Dietary habits were evaluated by a questionnaire which includes frequency of intake of meat, processed meat, chicken, fish, egg, legume, milk, dairy products, fruit, vegetable, bread, tea, coffee, coke, fast food, sugar, pasta, rice, chocolate, cake, cookie and pie. The questionnaire included options like every day, 3-5 times a week, 1-2 times a week, twice a month, once a month and none. Results: The frequency of intake of foods in the questionnaire was simlar between patients and healthy individuals except for vegetables. Vegetable consumption was significantly more common among patients than healthy individuals (p=0.04). Conclusions: The results showed that dietary habits were not associated with increased risk of seborrheic dermatitis.
Available via license: CC BY
Content may be subject to copyright.
Our Dermatology Online
© Our Dermatol Online 3.2018 261
How to cite this article: Tamer F. Relationship between diet and seborrheic dermatitis. Our Dermatol Online. 2018;9(3):261-264.
Submission: 27.11.2017; Acceptance: 13.01.2018
DOI: 10.7241/ourd.20183.6
Relationship between diet and seborrheic dermatitis
Relationship between diet and seborrheic dermatitis
Funda Tamer
Ufuk University School of Medicine, Department of Dermatology, Ankara, Turkey
Corresponding author: Dr. Funda Tamer, E-mail: fundatmr@yahoo.com
INTRODUCTION
Seborrheic dermatitis is a chronic inflammatory skin
disease which is characterised by erythematous scaly
plaques on the sebaceous areas like forehead, eyebrows,
glabella, nasolabial folds, scalp, chest, and back. The
prevalence of seborrheic dermatitis among adults in
the general population is 1-10%. It is more common
in men than in women. The disease usually presents
between the ages of 30 and 40 years [1]. The incidence
of seborrheic dermatitis is similar between ethnic
groups [2]. The exact cause of this condition remains
unknown. However, numerous factros including
Malassezia yeasts, sex hormones like androgens, sebum
levels, immune response, neurogenic factors and
stress have been implicated in the etiopathogenesis of
seborrheic dermatitis [3].
Sebaceous glands are distributed all over the skin
surface except palms and soles. However, the secretion
of sebum from sebaceous glands is highest on the scalp,
face, chest, and back [4]. Sebum has an important
role in the pathogenesis of seborrheic dermatitis [5].
It maintainces epidermal barrier function, carries
anti-oxidants to the skin surface and protects skin
from microbial colonization. Sebum is composed
of triglycerides, fatty acids, wax esters, sterol esters,
cholesterol, cholesterol esters, and squalene. Lipids
are used by Malassezia species for proliferation.
They degrade sebum, free fatty acids and leave the
unsaturates which cause inflammation, irritation and
scaling in seborrheic dermatitis [4].
Insulin and insulin-like growth factor-1 (IGF-1)
stimulate the lipogenesis of sebaceous glands by a
transcription factor named sterol regulatory element-
binding protein 1. It has been suggested that high
carbohydrate intake leads to reactive hyperinsulinemia
and increased IGF-1 production [6]. Zinc, riboflavin,
pyridoxine and niacin deficiency can lead to seborrheic
dermatitis-like lesions. Therefore, nutrition has
been associated with an increased risk of seborrheic
ABSTRACT
Background: Seborrheic dermatitis is a chronic inflammatory skin disease that affects 1-10% of the general population.
Malassezia yeasts, immune response and emotional stress have been implicated in the etiology of seborrheic dermatitis.
However, the effect of diet on development of seborrheic dermatitis is still controversial. This study investigates the
differences in the frequency of consumption of foods and food groups between patients with seborrheic dermatitis and
healthy individuals. Material and Methods: Fifty-one patients with seborrheic dermatitis of the scalp (28 female, 23 male)
and 50 healthy individuals within the control group (30 female, 20 male) have been included in this study. The mean age
of the patients and control group were 30.6±11.4 years and 32.7±10.7 years, respectively (p=0.35). Dietary habits were
evaluated by a questionnaire which includes frequency of intake of meat, processed meat, chicken, fish, egg, legume, milk,
dairy products, fruit, vegetable, bread, tea, coffee, coke, fast food, sugar, pasta, rice, chocolate, cake, cookie and pie. The
questionnaire included options like every day, 3-5 times a week, 1-2 times a week, twice a month, once a month and none.
Results: The frequency of intake of foods in the questionnaire was simlar between patients and healthy individuals except
for vegetables. Vegetable consumption was significantly more common among patients than healthy individuals (p=0.04).
Conclusions: The results showed that dietary habits were not associated with increased risk of seborrheic dermatitis.
Key words: Dandruff; Diet; Seborrhea; Seborrheic dermatitis
Brief Report
www.odermatol.com
© Our Dermatol Online 3.2018 262
dermatitis [2]. However, no exact relation has been
established yet [7].
The purpose of this study was to examine the frequency
of consumption of foods in patients with seborrheic
dermatitis and healthy subjects and determine the
relationship between dietary habits and seborrheic
dermatitis.
MATERIALS AND METHODS
This study included 51 patients with seborrheic
dermatitis of the scalp and 50 healthy individuals
within the control group. The exclusion criteria were
having an inflammatory skin disease like psoriasis,
lichen planus, having a chronic condition like diabetes,
hypertension, renal insufficiency, hypothyroidism,
hyperthyroidism, obesity, cancer, eating disorder, and
requiring a special diet.
Dietary intake was evaluated by a food frequency
questionnaire which consisted of frequency of intake of
meat, processed meat, chicken, fish, egg, legume, milk,
dairy products, fruit, vegetable, bread, tea, coffee, coke,
fast food, sugar, pasta, rice, chocolate, cake, cookie and
pie. The questionnaire included options such as every
day, 3-5 times a week, 1-2 times a week, twice a month,
once a month and none. All participants answered the
questionnaire based on their eating habit for the last
five years.
Statistical analysis was performed using SPSS 22.0
(SPSS Inc., Chicago, IL). Continuous variables were
defined as the means (±) standard deviations and
categorical variables as percentages. Differences
between groups were analysed by independent-samples
t-test for numerical variables and chi-square test for
categorical variables. A p-value <0.05 was considered
statistically significant.
RESULTS
Fifty-one patients with seborrheic dermatitis
(28 female, 23 male) and 50 healthy individuals within
Table 1: Information about the frequency of consumption of some foods among patients and control group
Patient (n=51) Groups Control (n=50) P-value
Meat None
Once a month
Twice a month
1-2 times a week
3-5 times a week
Everyday
1
4
4
25
14
3
2%
7.8%
7.8%
49%
27.5%
5.9%
0
4
4
16
21
5
0%
8%
8%
32%
42%
10%
0.43
Milk None
Once a month
Twice a month
1-2 times a week
3-5 times a week
Everyday
8
6
8
13
10
6
15.7%
11.8%
15.7%
25.5%
19.6%
11.8%
5
7
9
14
5
10
10%
14%
18%
28%
10%
20%
0.62
Fruit None
Once a month
Twice a month
1-2 times a week
3-5 times a week
Everyday
0
2
3
3
17
26
0%
3.9%
5.9%
5.9%
33.3%
51%
1
1
1
5
19
23
2%
2%
2%
10%
38%
46%
0.68
Bread None
Once a month
Twice a month
1-2 times a week
3-5 times a week
Everyday
2
0
1
5
8
35
3.9%
0%
2%
9.8%
15.7%
68.6%
1
0
1
4
6
38
2%
0%
2%
8%
12%
76%
0.93
Sugar None
Once a month
Twice a month
1-2 times a week
3-5 times a week
Everyday
7
2
5
7
15
15
13.7%
3.9%
9.8%
13.7%
29.4%
29.4%
10
4
4
5
5
22
20%
8%
8%
10%
10%
44%
0.16
Vegetable None
Once a month
Twice a month
1-2 times a week
3-5 times a week
Everyday
0
0
2
14
21
14
0%
0%
3.9%
27.5%
41.2%
27.5%
0
2
2
3
26
17
0%
4%
4%
6%
52%
34%
0.04
www.odermatol.com
© Our Dermatol Online 3.2018 263
the control group (30 female, 20 male) were included
in the study. The mean age of the patients and control
group were 30.6 ±11.4 years and 32.7±10.7 years,
respectively (p=0.35). The mean disease duration was
7.3±8.5 years. Dietary habits were similar between
the two groups except for vegetable intake (Table 1).
Consumption frequency of vegetable was everyday in
14 (27.5%) patients; 3-5 times a week in 21 (41.2%)
patients; 1-2 times a week in 14 (27.5%) patients;
twice a month in 2 (3.9%) patients. However, vegetable
consumption frequency was everyday in 17 (34%)
controls; 3-5 times a week in 26 (52%) controls;
1-2 times a week in 3 (6%) controls; twice a month in
2 (4%) controls and once a month in 2 (4%) controls.
Vegetable consumption was significantly more frequent
among patients than controls (p=0.04). There were no
statistically significant differences between patients and
healthy individuals in the frequency of intake of meat
(p=0.43), processed meat (p=0.94), chicken (p=0.33),
fish (p=0.70), egg (p=0.14), legume (p=0.53), milk
(p=0.62), dairy products; yogurt (p=0.28), cheese
(p=0.88), fruit (p=0.68), bread (p=0.93), tea, coffee
(p=0.20), coke (p=0.13), fast food (p=0.79), sugar
(p=0.16), pasta, rice (p=0.66), chocolate (p=0.34),
cake, cookie and pie (p=0.98).
DISCUSSION
Seborrheic dermatitis is characterized byhyperkeratosis,
parakeratosis, excess intercellular and intracellular
lipids. Epidermal keratinocytes consist of lipid
granules which play role in the skin permeability.
However, sebaceous glands are the main source
of lipids of skin surface [6]. Therefore, sebaceous
secretions are considered to play a pathogenetic
role in seborrheic dermatitis [8]. Sebaceous glands
provide lipid substrates for the Malassezia growth.
Sebum consists of 57.5% triglycerides, 26.0% wax
esters, 12.0% squalene, 3.0% cholesterol esters and
1.5% cholesterol [6]. Sebaceous gland secretions
metabolise to irritating unsaturated fatty acids by
Malassezia [4]. The prevelance of the disease is
directly correlated with increased sebaceous gland
activity [8]. Predilection sites are sebaceous gland rich
areas like face, ears, scalp and the upper trunk [6].
Patients with oily skin are prone to develop seborrheic
dermatitis [9]. When hygiene is poor as occurs in
neuropathic patients, the residual sebum on the
skin results in growth of Malassezia and seborrheic
dermatitis [10].
The effect of diet on increased sebum production
has been reported previously. It has been suggested
that dietary lipids like fatty acids, acetat and glucose
may be the source for sebum synthesis [6]. Frequent
consumption of carbohydrates with a high glycemic
index can lead to hyperinsulinemia. It istimulates
sebum secretion by increasing androgen levels [11].
Boelsma et al. investigated the effect of diet on the
skin conditions including hydration, sebum content,
and surface pH of the skin in 302 healthy subject.
They assessed dietary intake with food frequency
questionnaires and sebum content of the forehead with
the sebumeter. No association between the nutrients
in diet and sebum content of the skin have been
found. However, increased serum vitamin A levels were
related with decreased sebum content [12]. It has been
suggested that caloric restriction can reduce sebum
release. Pochi et al. evaluated sebaceous gland activity
in obese patients following a four to eight week-long
caloric deprivation. The study showed decrease in
sebaceous gland secretion in all patients [13].
Dietary changes shown to be benefical in the treatment
of skin diseases like psoriasis, scleroderma, acne,
rosacea, herpes, pemphigus, and Refsum’s disease [14].
Moreover, dietary recommendations have been reported
in the treatment of dandruff which is regarded as a mild
form of seborrheic dermatitis with scalp scaling [15,16].
Patients with dandruff were adviced to eat foods rich
in vitamin B, shellfish, red meat, sunflower seeds,
sardines, salmon, water based fruits and vegetables.
In addition to this, the patients were adviced to avoid
oily and greasy food products, sugar, junk foods, animal
fats, flour, and seafood [16]. Faulty eating habits
have also been reported to be related with seborrheic
dermatitis [9]. In 1967, Bett et al. measured the sugar
intake of 16 patients with seborrheic dermatitis and
two groups of control subjects with a questionary.
A control group included 16 healthy individuals and
the other included 16 patients suffering from warts.
The consumption of sugar by patients with seborrheic
dermatitis was found to be significantly higher than
two groups of control subjects [17].
However, the association between diet and seborrheic
dermatitis has not been clearly established yet. There
are no adequate number of studies in the literature.
Therefore, frequency of food consumption of patients
with seborrheic dermatitis and healthy individuals have
been compared in this study. No significant differences
have been observed between two groups except for
frequency of vegetable intake. Vegetable consumption
www.odermatol.com
© Our Dermatol Online 3.2018 264
was significantly more frequent among patients than
controls. This study indicates that diet doesn’t play
role in production of sebum in patients with seborrheic
dermatitis.
CONCLUSION
In conclusion, the results showed that dietary habits
were not associated with increased risk of seborrheic
dermatitis.
STATEMENT OF HUMAN AND ANIMAL
RIGHTS
All procedures followed were in accordance with the
ethical standards of the responsible committee on
human experimentation (institutional and national)
and with the Helsinki Declaration of 1975, as revised
in 2008.
STATEMENT OF INFORMED CONSENT
Informed consent was obtained from all patients for
being included in the study.
REFERENCES
1. Ijaz N, Fitzgerald D. Seborrhoeic dermatitis. Br J Hosp Med.
2017;78:88-91.
2. Borda LJ, Wikramanayake TC. Seborrheic dermatitis and
dandruff: a comprehensive review. J Clin Investig Dermatol.
2015;3:10.13188/2373-1044.1000019.
3. Bukvić Mokos Z, Kralj M, Basta-Juzbašić A, Lakoš Jukić I.
Seborrheic dermatitis: an update. Acta Dermatovenerol Croat.
2012;20:98-104.
4. Ro BI, Dawson TL. The role of sebaceous gland activity and scalp
microfl oral metabolism in the etiology of seborrheic dermatitis and
dandruff. J Investig Dermatol Symp Proc. 2005;10:194-7.
5. Inaloz HS, Kirtak N. The pathogenesis and treatment of
seborrhoeic dermatitis. T Klin J Med Sci. 2002;22:239-44.
6. Sakuma TH, Maibach HI. Oily skin: an overview. Skin Pharmacol
Physiol. 2012;25:227-35.
7. Schwartz RA, Janusz CA, Janniger CK. Seborrheic dermatitis: an
overview. Am Fam Physician. 2006;74:125-30.
8. Bakardzhiev Argirov A, Bakardzhiev I. New insights into the
etiopathogenesis of seborrheic dermatitis. Clin Res Dermatol Open
Access. 2017;4:1-5.
9. MacKee GM, Lewis GM. Dandruff and seborrhea: I. fl ora of
“normal” and diseased scalps. J Invest Dermatol. 1938;1:131-9.
10. Sampaio AL, Mameri AC, Vargas TJ, Ramos-e-Silva M, Nunes
AP, Carneiro SC. Seborrheic dermatitis. An Bras Dermatol.
2011;86:1061-71.
11. Costa A, Lage D, Moisés TA. Acne and diet: truth or myth? An
Bras Dermatol. 2010;85:346-53.
12. Boelsma E, van de Vijver LP, Goldbohm RA, Klöpping-Ketelaars
IA, Hendriks HF, Roza L. Human skin condition and its associations
with nutrient concentrations in serum and diet. Am J Clin Nutr.
2003;77:348-55.
13. Pochi PE, Downing DT, Strauss JS. Sebaceous gland response in
man to prolonged total caloric deprivation. J Invest Dermatol.
1970;55:303–9.
14. Basavaraj KH, Seemanthini C, Rashmi R. Diet in dermatology:
present perspectives. Indian J Dermatol. 2010;55:205-10.
15. Dessinioti C, Katsambas A. Seborrheic dermatitis: etiology, risk
factors, and treatments: facts and controversies. Clin Dermatol.
2013;31:343-51.
16. Mohamed HS, Farahat NH, Megallaa NG, Elhaleem MA. Nursing
guidelines on hair dandruff symptoms for adult patients. Life Sci
J. 2014;11:323-33.
17. Bett DG, Morland J, Yudkin J. Sugar consumption in acne vulgaris
and seborrhoeic dermatitis. Br Med J. 1967;3:153-5.
Copyright by Funda Tamer. This is an open-access article distributed
under the terms of the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium,
provided the original author and source are credited.
Source of Support: Nil, Confl ict of Interest: None declared.
... Seborrheic dermatitis is a manifestation of stage 2 HIV and accounts for a 1-10% prevalence in the general adult population [4]. Seborrheic dermatitis was present in 5.8% of our cases, which is a smaller percentage than that reached by other studies (up to 11.9%) [5]. ...
Mucocutaneous disorders in HIV/AIDS at a tertiary care hospital in Nepal: An observational study
Article
  • Apr 2021
Background: Mucocutaneous manifestations in HIV infections are common. However, they have not, so far, been studied in Nepal. The aim of this study was, therefore, to describe mucocutaneous manifestations in Nepalese HIV patients. Materials and Methods: The following is a hospital-based, descriptive, cross-sectional study conducted in the Department of Dermatology and Venereology and Antiretroviral Treatment (ART) Center of Tribhuvan University Teaching Hospital (TUTH) from May 2017, through October 2018. Patients aged 16 years and above diagnosed with HIV were included in the study, for whom history and clinical examinations were performed. The study variables were age, sex, a clinical diagnosis of dermatological problems, clinical stages of HIV/AIDS, as per the World Health Organization (WHO) classification criteria, and the CD4 count. Results: A total of 52 patients were included in the study. The mean age upon presentation was 38.77 ± 10.9 years. The mean CD4 count was 464.27 ± 255.13. Females were more affected than males (female:male = 1.4:1). Mucocutaneous manifestations were the following: fungal infections (10; 19.3%), viral infections (6; 11.6%), parasitic infestations (3; 5.8%), bacterial infections (4; 7.7%), sexually transmitted infections (2; 3.8%), seborrheic dermatitis (3; 5.8%), idiopathic pruritus (3; 5.8%), recurrent oral ulcers (3; 5.8%), urticaria (3; 5.8%), pruritic papular eruptions (2; 3.8%), eczemas (2; 3.8%), acne (2; 3.8%), angular cheilitis (2; 3.8%), xerosis cutis (2; 3.8%), and others (5; 9.6%). Conclusions: The study showed that fungal infections are common in HIV patients, followed by viral infections and parasitic infestations. Seborrheic dermatitis, idiopathic pruritus, recurrent oral ulcers, and urticaria were found to be common inflammatory skin diseases in HIV.
... Increased levels of vitamin A in the blood has also been linked to a decreased sebum production [291]. Dandruff patients are often advised to avoid sugar, animal fats, and greasy food products and instead consume more vegetables, water-based fruits, seeds, fish, biotin, and vitamin B, although no conclusive evidence has been found for such recommendations [292]. ...
Gut–Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin Conditions
Article
Full-text available
  • Feb 2021
The microbiome plays an important role in a wide variety of skin disorders. Not only is the skin microbiome altered, but also surprisingly many skin diseases are accompanied by an altered gut microbiome. The microbiome is a key regulator for the immune system, as it aims to maintain homeostasis by communicating with tissues and organs in a bidirectional manner. Hence, dysbiosis in the skin and/or gut microbiome is associated with an altered immune response, promoting the development of skin diseases, such as atopic dermatitis, psoriasis, acne vulgaris, dandruff, and even skin cancer. Here, we focus on the associations between the microbiome, diet, metabolites, and immune responses in skin pathologies. This review describes an exhaustive list of common skin conditions with associated dysbiosis in the skin microbiome as well as the current body of evidence on gut microbiome dysbiosis, dietary links, and their interplay with skin conditions. An enhanced understanding of the local skin and gut microbiome including the underlying mechanisms is necessary to shed light on the microbial involvement in human skin diseases and to develop new therapeutic approaches.
... There is alteration in skin surface lipids where squalene increases. A positive correlation was found between the degree of squalene peroxidation and the size of the comedones elicited [12]. People experience more seborrhea in the summer than in the winter. ...
Unmasking the mask: COVID-19 manifestations of PPE kits
Article
  • Dec 2020
The world is now facing a new unexpected pandemic caused by SARS-CoV-2, which is a coronavirus that mainly targets the lungs, a very vital and sensitive organ of the body. Research and healthcare workers are still struggling to contain the disease and eradicate the virus. Before the invention of a vaccine, the virus may take at least several more millions of lives. On top of this, dermatologists are facing numerous challenges because of the regulations put forward by the WHO and local governments. This article discusses in detail various dermatological eruptions caused by the personal protective equipment (PPE) used in combating the disease. This should be an eye-opener for dermatologists worldwide.
... They should also stop drinking beer, alcohol, coffee, tobacco and stimulants 8 . "Dietary changes" are beneficial in the treatment and Tamer (2018) mentioned that patients should eat foods rich in vitamin B, salmon, vegetables and fruits 7 . ...
Knowledge and Perception of Physiotherapy among Clinical Students in Various Health Care Disciplines of a Nigerian College of Medicine and Health Sciences
Article
Full-text available
  • Jul 2019
Background: The delivery of effective interprofessional co-operation in health practice is essential for successful treatment outcomes. Interprofessional education has been seen to be a major means of improving the knowledge of students about other health disciplines and encouraging future co-operations in health practice. The study therefore aims at investigating health sciences students’ knowledge and perceptions of physiotherapy, to enable the planning of a relevant interdisciplinary curriculum that includes all clinical students. Method: A total of 404 undergraduate clinical students [Males = 219, Females =185] in various health programmes participated in this study. A cross-sectional design was utilized for the study. A convenience sampling technique was utilized. Copies of the questionnaire were self-administered and data collected on the same day. The questionnaire was distributed in lecture halls and students’ hostels and students were expected to respond to the sections bordering on their socio-demographics, knowledge and perception of physiotherapy. Descriptive statistics using frequencies and percentages was used to analyse data on knowledge and perception of physiotherapy. Results: A low level of knowledge of physical modalities and treatment procedures utilized by physiotherapists was observed across the various health care disciplines. A positive perception of physiotherapy was observed. Classroom lectures was identified as the most common source of knowledge of physiotherapy. Conclusion: A low level of knowledge of the various physiotherapy treatment procedures and modalities was observed among clinical students in the various health care disciplines. An improved interdisciplinary curriculum in the various colleges of medicine may foster the increase in knowledge of physiotherapy, hence promoting interdisciplinary health care.
An overview on seborrheic dermatitis and its treatment (allopathy and homeopathy)
Article
Full-text available
  • Aug 2020
Seborrheic dermatitis is a common, chronic inflammation of the skin, characterized by the appearance of red, flaking, greasy areas of skin, most commonly on the scalp, nasolabial folds, ears, eyebrows and chest. The incidence of the disease has two peaks: one in newborn infants up to three months of age, and the other in adults of around 30-60years of age. The exact causes of seborrheic dermatitis are not completely understood, multiple factors appears to be involved in the pathophysiology of the disease. The principle three factors involved are: sebum secreted from sebaceous gland, presence of Malassezia yeast, and the immune response of the host. Currently allopathic treatment and prophylaxis regimens usually include antifungal agents, most often azoles, mild topical steroids, immunomodulatory activity of topical calcineurin inhibitors such as tacrolimus and pimecrolimus and other agents such as selenium sulfide, sulfur, metronidazole and coal tar. Homeopathy offers an excellent treatment for seborrheic dermatitis during all stages. Various homeopathic medicine used to treat seborrheic dermatitis are kali sulphuricum, thuja occidentalis, natrum muriaticum and more. The objective of this review is to discuss and provide information about seborrheic dermatitis and its epidemiology, etiology, pathogenesis, symptoms, diagnosis and its treatment in allopathy and homeopathy.
Postherpetic oral ulcers misdiagnosed as pemphigus in a patient with rheumatoid arthritis under bucillamine therapy
Article
Full-text available
  • Nov 2013
Autoimmune bullous disease is sometimes seen in patients with rheumatoid arthritis (RA). In addition, pemphigus can be induced by certain disease modifying anti-rheumatic drugs (DMARDs) for RA, such as thiol compounds. Antibodies against desmogleins are occasionally detected in the sera of drug-induced pemphigus patients. We herein describe a case which showed ulceration following herpes zoster in the oral cavity of a patient with RA under treatment with bucillamine. The patient was misdiagnosed with pemphigus in another clinic, because of mucous membrane lesions and positive circulating levels of anti-desmoglein-1 IgG. Clinicians should know that circulating antibodies against desmogleins can be detected, although at low titers, in the sera of patients under therapies with certain drugs.
New Insights into the Etiopathogenesis of Seborrheic Dermatitis
Article
Full-text available
  • Feb 2017
Seborrheic dermatitis represents a chronic, widespread skin disease that is considered a multifactorial disorder influenced, in part, by Malassezia spp.opportunistic activities as well as by various endogenous and exogenous factors. This review systematizes the recent scientific achievements in the field of insufficiently elucidated etiology and pathogenesis of seborrheic dermatitis.
Seborrheic Dermatitis and Dandruff: A Comprehensive Review
Article
Full-text available
  • Dec 2015
Seborrheic Dermatitis (SD) and dandruff are of a continuous spectrum of the same disease that affects the seborrheic areas of the body. Dandruff is restricted to the scalp, and involves itchy, flaking skin without visible inflammation. SD can affect the scalp as well as other seborrheic areas, and involves itchy and flaking or scaling skin, inflammation and pruritus. Various intrinsic and environmental factors, such as sebaceous secretions, skin surface fungal colonization, individual susceptibility, and interactions between these factors, all contribute to the pathogenesis of SD and dandruff. In this review, we summarize the current knowledge on SD and dandruff, including epidemiology, burden of disease, clinical presentations and diagnosis, treatment, genetic studies in humans and animal models, and predisposing factors. Genetic and biochemical studies and investigations in animal models provide further insight on the pathophysiology and strategies for better treatment.
Seborrheic dermatitis
Article
Full-text available
  • Nov 2011
Seborrheic dermatitis is a chronic relapsing erythematous scaly skin disease, the prevalence of which is around 1 to 3% of the general population in the United States. It has two incidence peaks, the first in the first three months of life and the second beginning at puberty and reaching its apex at 40 to 60 years of age. The prevalence of seborrheic dermatitis is higher in HIV-positive individuals and the condition tends to be more intense and refractory to treatment in these patients. Neurological disorders and other chronic diseases are also associated with the onset of seborrheic dermatitis. The currently accepted theory on the pathogenesis of this disease advocates that yeast of Malassezia spp., present on the skin surface of susceptible individuals, leads to a non-immunogenic irritation due to the production of unsaturated fatty acids deposited on the skin surface. This article provides a review of the literature on seborrheic dermatitis, focusing on immunogenetics, the clinical forms of the disease and its treatment.
Seborrheic dermatitis: Etiology, risk factors, and treatments: Facts and controversies
Article
  • Jul 2013
Seborrheic dermatitis (SD) is a common skin condition seen frequently in clinical practice. The use of varying terms such as sebopsoriasis, seborrheic dermatitis, seborrheic eczema, dandruff, and pityriasis capitis reflects the complex nature of this condition. Despite its frequency, much controversy remains regarding the pathogenesis of SD. This controversy extends to its classification in the spectrum of cutaneous diseases, having being classified as a form of dermatitis, a fungal disease, or an inflammatory disease, closely related with psoriasis. Some have postulated that SD is caused by Malassezia yeasts, based on the observation of their presence in affected skin and the therapeutic response to antifungal agents. Others have proposed that Malassezia is incidental to a primary inflammatory dermatosis that resulted in increased cell turnover, scaling, and inflammation in the epidermis, similar to psoriasis. The presence of host susceptibility factors, permitting the transition of M furfur to its pathogenic form, may be associated with immune response and inflammation. Metabolites produced by Malassezia species, including oleic acid, malssezin, and indole-3-carbaldehyde, have been implicated. SD also has been traditionally considered to be a form of dermatitis based on the presence of Malassezia in healthy skin, the absence the pathogenic mycelial form of Malassezia yeasts in SD, and its chronic course. As a result, proposed treatments vary, ranging from topical corticosteroids to topical antifungals and antimicrobial peptides.
Seborrheic Dermatitis: An Update
Article
  • Jun 2012
Seborrheic dermatitis is a chronic relapsing inflammatory skin disorder clinically characterized by scaling and poorly defined erythematous patches. The prevalence of adult seborrheic dermatitis is estimated at 5%. Although the exact cause of seborrheic dermatitis has yet to be understood, Malassezia yeasts, hormones (androgens), sebum levels and immune response are known to play important roles in its development. Additional factors including drugs, winter temperatures and stress may exacerbate seborrheic dermatitis. A variety of treatment modalities are available, including antifungal agents, topical low-potency steroids and calcineurin inhibitors (immunomodulators). This review summarizes current knowledge on the etiopathogenesis and therapy of adult seborrheic dermatitis.
Oily Skin: An Overview
Article
Oily skin (seborrhea) is a common cosmetic problem that occurs when oversized sebaceous glands produce excessive amounts of sebum giving the appearance of shiny and greasy skin. This paper overviews the main concepts of sebaceous gland anatomy and physiology, including the biosynthesis, storage and release of sebum, as well as its relationship to skin hydration and water barrier function. We also address how skin oiliness may vary according to diet, age, gender, ethnicity and hot humid climates. The deeper understanding of this skin type provides the opportunity to better guide patients regarding skin care and also assist in the development of sebosuppressive agents.
Diet in Dermatology: Present perspectives.
Article
  • Mar 2010
Many nutrients are essential for life, and an adequate amount of nutrients in the diet is necessary for providing energy, building and maintaining body organs, and for various metabolic processes. The role of food in the induction of various skin disorders and skin diseases leading to nutritional deficiencies is well known. The photo-protective potential of antioxidants, the effects of micronutrient supplementation on the skin immune system, and the modulating effects of fatty acids on skin disorders are well documented. Skin diseases due to nutritional deficiencies, the dietary role in skin immunity and various skin diseases, and the role of antioxidants and other supplements in skin health have been reviewed.
Sebaceous Gland Response in Man to Prolonged Total Caloric Deprivation
Article
  • Nov 1970
The response of the sebaceous gland to total caloric deprivation was studied in 18 obese patients undergoing fasts for periods of four to eight weeks. Sebum production was measured in 11 of the patients and was found to decrease in each individual, with an average reduction of 40%. Diminished secretion usually occurred by the fourth week but was sometimes seen as early as one or two weeks. The composition of the sebum, analyzed in 14 patients, was also altered, and this could be detected as early as five days after the onset of fast. The qualitative changes in surface lipid consisted of a reduction in the amount of triglyceride fatty acids, wax esters, cholesterol and cholesterol esters but with no significant alteration in the amount of squalene.