Seborrhoeic dermatitis: current treatment practices

Abstract

Seborrhoeic dermatitis (SD) is a recurrent, chronic inflammation of the skin that occurs on sebum rich areas such as the face, scalp and chest, characterised by red scaly lesions. The are many studies indicating that Malassezia yeasts play an important role in the aetiology of this condition, most of the evidence for which comes from demonstrated responsiveness to treatment with antifungal agents. Its aetiology, however, is far from being resolved. Some believe that it is the immune response of the skin to the Malassezia that is the cause of the disease. Traditional treatments of SD have been the use of keratolytic agents or corticosteroids. Since the discovery of ketoconazole, a considerable amount of research has been focused on determining the efficacy of various antifungal agents. This article reviews clinical trial data on treatment options available for SD.

Fungal virulence, vertebrate endothermy, and dinosaur extinction: is there a connection?

“…rarely causes systemic disease unless the patient is receiving intravenous lipid therapy, which provides essential nutrients for fungal growth. However, this organism can cause skin disease, such as seborrhoeic dermatitis, which is believed to result from the immune response to fungal antigens (Gupta and Kogan, 2004). The second group of fungal pathogens is acquired from the environment and includes B. dermatitidis, C. neoformans, Coccidioides spp., H. capsulatum, Paracoccidioides brasiliensis, and Sporothrix schenckii.…”

Dermatophytosis (Tinea) and Other Superficial Fungal Infections

“…Seborrheic dermatitis is a chronic, recurrent disorder affecting between 1 and 5 % of immunocompetent adults [3,14,15]. It is typically referred to as dandruff.…”

“…Pruritus, irritation, and a tight, dry feeling may be associated with the afflicted area [32]. Some cases present with little erythema, while others present as a sore scalp with occasional pustules [15].…”

“…There is no definitive cure for SD; it is a recurrent disease requiring prophylactic treatment [15]. Topical corticosteroid lotions have typically been used but are being replaced by antifungals in the form of shampoos, gels, and creams (Table 21.2).…”

“…Zinc pyrithione shampoos are safe and effective in controlling dandruff and SD of the scalp, and exhibit strong keratolytic and antifungal activity against Malassezia [16,57]. Some patients benefit as well from non-antifungal, keratolytic agents (selenium sulfide, sulfur, salicylic acid) or anti-proliferative (coal tar) shampoos [15,32]. Tar shampoos often cause sensitivity of the skin to sunlight and are not as favorable cosmetically [32].…”