J Faergemann's research while affiliated with Sahlgrenska University Hospital and other places

... globosa and M. restricta). The resurgence of interest in Malassezia in D/SD supports that dandruff and seborrheic dermatitis are manifestations of the same disorder differing only in severity (Priestley and Savin 1976; Kligman 1979; McGrath and Murphy 1991; Danby et al. 1993; Bulmer and Bulmer 1999; Faergemann 2000b; Pierard-Franchimont et al. 2000; Warner et al. 2001). D/SD most commonly first appears in adolescents and young adults, likely because of the increase in sebaceous activity during puberty (Ramasastry et al. 1970; Cotterill et al. 1972). ...

... Members of the genus Malassezia have become noticed as opportunistic yeasts of increasing importance in recent years by dermatologists and mycologists [4][5][6][7]. Out of 14 recognized species of Malassezia [8], a small genome size, spanning ∼9 Mb, Malassezia globosa is associated with skin diseases [9] such as pityriasis versicolor [10], seborrhoeic dermatitis and dandruff [11]. Treatment involves the use of ketoconazole, selenium sulfide, zinc pyrithione, ciclopirox olamine, climbazole [12] but termination of the treatment often leads to the reoccurrence of the symptoms [13]. ...

... This drug is a lipophilic allylamine compound. terbinafine penetrates keratinized tissues, and enters the stratum corneum and sebum by direct diffusion through the dermis and living epidermis (Faergemann 1997, Faergemann et al. 1990. ...

... However, recurrences are frequently described after a well-managed treatment. e recurrence rate is estimated at 60% after one year and can reach 80% in the second year [5]. In general, the resistance of mycoses to antifungal agents has become a major concern in clinical practice over the last 30 years. ...

... However, no studies have assessed the systemic exposure of higher-dose terbinafine treatment (Ͼ250 mg daily) or divided daily doses (every 12 h [q12h] or q8h), factors that are likely to be crucial to the utility of terbinafine in effectively treating systemic mycoses in combination with other antifungals. This paucity of pharmacokinetic data is particularly important for terbinafine due to its very long terminal elimination half-life (2 to 3 weeks [13]) and substantial accumulation in plasma over time; trough terbinafine concentrations following 250 mg once daily are known to accumulate Ͼ10-fold over 12 to 20 weeks (14), with the majority of the accumulation occurring in the first 4 weeks of therapy (13). ...

... Terbina ne has a fungicidal mode of action [8,16] which is assumed to contribute substantially to its ability to achieve rapid mycological and clinical response. It has also been shown to penetrate rapidly into the stratum corneum and to maintain high tissue levels for several weeks after discontinuation of treatment [17,18]. By contrast, azole agents such as clotrimazole and ketoconazole are primarily fungistatic. ...

... Dandruff is caused by the commensal lipophilic yeast and hence cannot be completely eliminated but can only be managed. Recent years for the treatment of dandruff, a variety of the synthetic chemicals with anti-malassezial activity such as Ketoconazole, Zinc pyrithione, Octopirox, Climbazole (Faergemann, 1996) and natural ingredients like Hyamarka (veppalai), Tea tree oil, Neem, Rosemary oil and Chamomile oil are commercially used in shampoos, lotions, creams and hair oils. However, these shampoos have to be used for a long period and leave scalp skin dry (which leads to frequent scalp irritation), and are also known to discolor light colored hair. ...

... Antifungals may be beneficial in scalp psoriasis resistant to other topical or systemic treatment (64). Although one study supports this notion (65), this is refuted by another trial (66). More placebo-controlled, randomized controlled studies are required to clarify this result. ...

... Only one strain in our study showed an increased MIC to ITZ. As reported by some authors [8,16,37,38], M. pachydermatis is highly susceptible to KTZ and ITZ which is consistent with the results observed in our study. Since now, only two M. pachydermatis isolates have demonstrated to be resistant to both ITZ and KTZ [22,23]. ...

... [8] Topical antifungal drugs or topical corticosteroids are usually the first line of treatment for seborrheic dermatitis, which is sometimes used in combination. [9][10][11] Triamcinolone is a corticosteroid that blocks the release of substances that cause inflammation in the body. It is used to treat various diseases such as eczema, allergies, lupus, psoriasis, alopecia, asthma, and autoimmune arthritis. ...