SUMMARY Quantitative aerobic cultures were obtained from fifty patients with chronic plaques, and from twenty with exudative lesions of atopic dermatitis. In the former, Staphylococcus aureus was isolated from 90% and the density exceeded 1 × 106/cm2 in 45% of the samples. In the exudative form, Staph. aureus was recovered in every case with a mean density of 14 × 106 organisms per cm2. Staph. aureus was the dominant organism not only in the lesions but in nearby clinically normal skin. Despite these high numbers, clinical signs of infection were lacking. Systemic and topical antibiotic therapy pro‐duced a profound decrease in Staph. aureus density. It is proposed that high numbers of Staph. aureus may aggravate the underlying lesion and be the source of Staph. aureus infections in contacts.

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The composition of the scalp microflora was assessed quantitatively in normal individuals and in patients with dandruff and seborrheic dermatitis, disorders characterized by increasing scaling. Three organisms were constantly found: (1) Pityrosporum, (2) aerobic cocci, and (3) Corynebacterium acnes. Pityrosporum (mainly Pityrosporum ovale) made up 46% of the total microflora in normals, 74% in dandruff, and 83% in seborvheic dermatitis. The geometric mean number of organisms per cm-2 in non-dandruff subjects was 5.04 times 10-5; 9.22 times 10-5 in dandruff subjects; and 6.45 times 10-5 in those with seborrheic dermatitis. The cocci were dominantly Baird-Parker type SII and no quantitative or qualitative change occurred in the scaling disorders. C. acnes comprised 26% of the flora on the normal scalp, 6% in dandruff, and only 1% in seborrheic dermatitis. These results differ significantly from previous reports which describe a much more complex microflora and suggest an etiologic role for microorganisms in dandruff.

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