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Fonseka S, Narankotuwa KHH, Bandara DDJ. Light-emitting Diode Light Therapy for Facial Seborrhoeic Dermatitis: A Case Report. J Cutan Aesthet Surg 2021; 14:241-243. [PMID: 34566371 PMCID: PMC8423200 DOI: 10.4103/jcas.jcas_188_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Seborrhoeic dermatitis (SD) is a chronic, relapsing, papulosquamous inflammatory itchy dermatoses. It manifests as erythematous papules, macules, or ill-defined flat plaques with varying levels of scaling and pruritus. The exact pathogenesis of this condition is not known but Malassezia yeasts, hormones (androgens), amount of sebum produced, and deranged immune response are known to play important roles in its development. There is a wide range of therapeutic options to treat SD but some patients do not respond to any of the treatments. Here, we report three patients with treatment-resistant facial SD, successfully treated with light-emitting diode light therapy (LED-LT).
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Affiliation(s)
- Sanjeewani Fonseka
- Department of Pharmacology, Faculty of Medicine, University of Peradeniya, Galaha Rd, Sri Lanka
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Honnavar P, Chakrabarti A, Dhaliwal M, Dogra S, Handa S, Lakshmi PVM, Rudramurthy SM. Sociodemographic characteristics and spectrum of Malassezia species in individuals with and without seborrhoeic dermatitis/dandruff: A comparison of residents of the urban and rural populations. Med Mycol 2021; 59:259-265. [PMID: 32556200 DOI: 10.1093/mmy/myaa050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/29/2020] [Accepted: 06/03/2020] [Indexed: 12/22/2022] Open
Abstract
Seborrhoeic dermatitis/dandruff (SD/D) is a common, persistent, relapsing inflammatory condition affecting the areas rich in sebaceous glands. SD/D is widely prevalent in India but Malassezia species implicated are not well studied. To estimate the prevalence and spectrum of Malassezia species causing SD/D and understand the sociodemographic characteristics of SD/D in rural and urban populations, a total of 200 SD/D patients and 100 healthy controls (HC) from both rural and urban backgrounds were enrolled in this study. SD/D severity was clinically graded as mild, moderate, severe, and very severe. The isolates were identified by phenotypic characters and confirmed by ITS2 PCR-RFLP and sequencing of the ITS region of rDNA. Severe (59%) and very severe (71%) form of SD/D was higher in the rural population compared to the urban population (P = .004). The isolation rate of Malassezia was significantly higher in overall SD/D patients scalp (82%) compared to HC (67%) (P = .005). From the scalp of SD/D patients, M. globosa (36.2%) was predominantly isolated followed by M. restricta (31.3%), M. furfur (15.7%), a mixture of M. globosa and M. restricta (12%) or M. arunalokei (4.8%). Similarly, M. globosa (49.3%) was predominately isolated from the scalp of HC followed by M. restricta (22.4%). M. restricta was significantly higher in the scalp of SD/D patients compared to HC and/or nasolabial fold of both SD/D patients and HC (P = .0001). Our findings indicate that M. restricta has a high association with SD/D. More severe disease frequency was observed in the rural population. PRECIS Dandruff is associated with Malassezia restricta and very severe cases are higher in rural population, probably due the poor hygiene. Moderate to severe hair loss and itching were strongly associated with dandruff. Use of soaps to cleanse scalp appears to be better than shampoo in preventing dandruff.
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Affiliation(s)
| | | | | | - Sunil Dogra
- Dept. of Dermatology, Leprosy and Venereology
| | | | - P V M Lakshmi
- Dept. of Community Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Lancar R, Missy P, Dupuy A, Beaulieu P, Fardet L, Costagliola D, Chosidow O. Risk Factors for Seborrhoeic Dermatitis Flares: Case-control and Case-crossover Study. Acta Derm Venereol 2020; 100:adv00292. [PMID: 33047149 PMCID: PMC9274933 DOI: 10.2340/00015555-3661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Patients with flares of seborrhoeic dermatitis were compared with control outpatients seen during the same time-period in a case-control study, and with themselves while in remission in a case-crossover study. All patients consulted the same office-based dermatologist. During the study period, 189 cases and 189 controls were included in the case-control study, and 81 cases in the case-crossover study. Multivariate analysis was performed. Case-control study results were the following: past history of tobacco consumption (odds ratio (OR) 2.2 (95% confidence interval (CI) 1.1–4.6)), conflict as a dispute during the past month (OR 10.6 (95% CI 1.0–114.3)), alcohol consumption on a regular basis (OR 10.2 (95% CI 2.0–52.6)), and higher level of stress during the past month (OR 8.2 (95% CI 3.4–19.9)). Case-crossover study results were the following: higher level of stress during the past month (OR 4.5 (1.7–12.2)), association borderline significant for higher level of alcohol consumption (OR 5.4 (0.8–34.9)). These risk factors for flares of seborrhoeic dermatitis should be taken into account carefully in the daily management of seborrhoeic dermatitis.
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Affiliation(s)
- Rémi Lancar
- Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Sorbonne Université, INSERM, Paris, France
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Al‐Janabi A, Marsland AM. Seborrhoeic dermatitis and sebopsoriasis developing in patients on dupilumab: Two case reports. Clin Case Rep 2020; 8:1458-1460. [PMID: 32884774 PMCID: PMC7455398 DOI: 10.1002/ccr3.2871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/15/2020] [Accepted: 03/29/2020] [Indexed: 01/24/2023] Open
Abstract
Cutaneous adverse events to dupilumab can be varied; this necessitates keeping a broad differential diagnosis to identify seemingly paradoxical reactions. It may be possible to treat the adverse event concurrently without stopping dupilumab.
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Affiliation(s)
- Ali Al‐Janabi
- The Dermatology CentreSalford Royal NHS Foundation TrustManchester NIHR Biomedical Research CentreManchester Academic Health Science CentreSalfordUK
- Division of Musculoskeletal and Dermatological SciencesSchool of Biological SciencesFaculty of Biology, Medicine and HealthThe University of ManchesterSalfordUK
| | - Alexander M. Marsland
- The Dermatology CentreSalford Royal NHS Foundation TrustManchester NIHR Biomedical Research CentreManchester Academic Health Science CentreSalfordUK
- Division of Musculoskeletal and Dermatological SciencesSchool of Biological SciencesFaculty of Biology, Medicine and HealthThe University of ManchesterSalfordUK
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7
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Pedrosa AF, Lisboa C, Branco J, Almeida AC, Mendes C, Pellevoisin C, Leite-Moreira A, Miranda IM, Rodrigues AG. Malassezia colonisation on a reconstructed human epidermis: Imaging studies. Mycoses 2019; 62:1194-1201. [PMID: 31556177 DOI: 10.1111/myc.13011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 09/19/2019] [Accepted: 09/22/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND Biofilm formation represents a major microbial virulence attribute especially at epithelial surfaces such as the skin. Malassezia biofilm formation at the skin surface has not yet been addressed. OBJECTIVE The present study aimed to evaluate Malassezia colonisation pattern on a reconstructed human epidermis (RhE) by imaging techniques. METHODS Malassezia clinical isolates were previously isolated from volunteers with pityriasis versicolor and seborrhoeic dermatitis. Yeast of two strains of M furfur and M sympodialis were inoculated onto the SkinEthic™ RHE. The tissues were processed for light microscopy, wide-field fluorescence microscopy and scanning electron microscopy. RESULTS Colonisation of the RhE surface with aggregates of Malassezia yeast entrapped in a multilayer sheet with variable amount of extracellular matrix was unveiled by imaging techniques following 24, 48, 72 and 96 hours of incubation. Whenever yeast were suspended in RPMI medium supplemented with lipids, the biofilm substantially increased with a dense extracellular matrix in which the yeast cells were embedded. Slight differences were found in the biofilm architectural structure between the two tested species with an apparently higher entrapment and viscosity in M furfur biofilm. CONCLUSION Skin isolates of M furfur and M sympodialis were capable of forming biofilm in vitro at the epidermal surface simulating in vivo conditions. Following 24 hours of incubation, without added lipids, rudimental matrix was barely visible, conversely to the reported at plastic surfaces. The amount of biofilm apparently increased progressively from 48 to 96 hours. A structural heterogeneity of biofilm between species was found.
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Affiliation(s)
- Ana Filipa Pedrosa
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Dermatology and Venereology, Centro Hospitalar Universitário S.João EPE, Porto, Portugal.,CINTESIS-Center for Health Technology and Services Research, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Carmen Lisboa
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Dermatology and Venereology, Centro Hospitalar Universitário S.João EPE, Porto, Portugal.,CINTESIS-Center for Health Technology and Services Research, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Joana Branco
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS-Center for Health Technology and Services Research, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Ana C Almeida
- Chromosome Instability & Dynamics Laboratory, Instituto de Biologia Molecular e Celular, University of Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal.,Graduate Program in Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Claudia Mendes
- Department of Surgery and Physiology, Cardiovascular R&D Centre, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Adelino Leite-Moreira
- Department of Surgery and Physiology, Cardiovascular R&D Centre, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Isabel M Miranda
- Department of Surgery and Physiology, Cardiovascular R&D Centre, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Acacio G Rodrigues
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.,CINTESIS-Center for Health Technology and Services Research, Faculty of Medicine of the University of Porto, Porto, Portugal.,Department of Plastic and Reconstructive Surgery, Burn Unit, Centro Hospitalar Universitário S.João EPE, Porto, Portugal
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Maarouf M, Platto JF, Shi VY. The role of nutrition in inflammatory pilosebaceous disorders: Implication of the skin-gut axis. Australas J Dermatol 2018; 60:e90-e98. [PMID: 30175843 DOI: 10.1111/ajd.12909] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 07/24/2018] [Indexed: 12/11/2022]
Abstract
Nutrition plays a critical role in the manifestation and management of inflammatory pilosebaceous disorders. There is rich potential for insight into the impact of dietary effects on the pathophysiology of inflammatory pilosebaceous disorders including acne vulgaris, hidradenitis suppurativa, rosacea, and the closely related seborrhoeic dermatitis. Acne vulgaris and hidradenitis suppurativa are thought to have similar diet-modulating pathogenic pathways. Western diet influences Acne vulgaris and hidradenitis suppurativa by increasing insulin and modulating FOX01/mTOR, resulting in over-expression of cytokeratins, hyperproliferation of keratinocytes, and hypercornification of the follicular wall. Key receptors in rosacea are alternatively activated by UV radiation, hot beverages, spicy foods, vanilla, cinnamon, caffeine, alcohol, cold temperatures, and niacin- and formalin-containing foods, to increase oedema and flushing, resulting in erythema, telangiectasia, and warmth, characteristic features of the condition. Seborrhoeic dermatitis, while not a follicular disorder, is closely related, and can be modulated by dietary influences, such as biotin and probiotics. This overview summarizes the role that nutrition plays on these disorders, and identifies dietary modifications as potential adjunctive therapies.
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Affiliation(s)
- Melody Maarouf
- College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Jody F Platto
- College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Vivian Y Shi
- Dermatology Division, Department of Medicine, University of Arizona, Tucson, Arizona, USA
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9
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Spada F, Barnes TM, Greive KA. Comparative safety and efficacy of topical mometasone furoate with other topical corticosteroids. Australas J Dermatol 2018; 59:e168-e174. [PMID: 29411351 PMCID: PMC6099284 DOI: 10.1111/ajd.12762] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 10/28/2017] [Indexed: 11/26/2022]
Abstract
Derivatives of hydrocortisone, such as mometasone furoate, a (2′) furoate‐17 ester with chlorine substitutions at positions 9 and 21, have been designed to improve efficacy and reduce the incidence of adverse effects. An extensive literature search of MEDLINE, Embase and other databases was conducted to review the safety and efficacy of various formulations of topical mometasone furoate. Mometasone furoate exhibits high potency with greater anti‐inflammatory activity and a longer duration of action than betamethasone. In clinical trials, mometasone furoate shows comparable or significantly better efficacy, depending on the comparator, in all indications studied in both adults and children. It is well tolerated with only transient, mild to moderate local adverse effects. It is characterised by low systemic availability due to its high lipophilicity, low percutaneous absorption and rapid hepatic biotransformation, and consequently has no significant effect on the hypothalamic‐pituitary‐adrenal axis. The molecular biotransformation of mometasone furoate in the skin results in a lower affinity with dermal cells than epidermal cells, which contributes to its low atrophogenicity. Sensitisation to mometasone furoate is low. Overall, mometasone furoate is a highly efficacious potent corticosteroid with a low risk of both local and systemic adverse effects.
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Patrizi A, Neri I, Ricci G, Cipriani F, Ravaioli GM. Advances in pharmacotherapeutic management of common skin diseases in neonates and infants. Expert Opin Pharmacother 2017; 18:717-725. [PMID: 28429969 DOI: 10.1080/14656566.2017.1316371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION neonatal and infantile skin diseases are frequently encountered in the clinical practice and represent worldwide a socioeconomic issue. They encompass a wide range of acquired or congenital conditions, including infections, vascular lesions and inflammatory diseases and can present with different degrees of severity, leading in some cases to dramatic complications. Areas covered: In this paper we report the most recent evidences on the management of some common skin diseases in neonates and infants. Hemangiomas, viral, fungal and bacterial infections, omphalitis, atopic and seborrhoeic dermatitis, napkin disease will be treated and discussed. Expert opinion: The majority of the dermatologic alterations in neonates are physiological, transient and do not require any treatment, thus the parents can be reassured about the good prognosis. However, in some cases, serious conditions must be excluded. In particular neonatal and infantile infections should be promptly recognized and properly managed, to avoid severe complications. The therapeutic options include traditional and, although few, innovative medical treatments, which will be carefully taken into consideration by the expert Dermatologists and Paediatricians.
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Affiliation(s)
- Annalisa Patrizi
- a Dermatology, Department of Experimental, Diagnostic and Specialty Medicine , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - Iria Neri
- a Dermatology, Department of Experimental, Diagnostic and Specialty Medicine , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - Giampaolo Ricci
- b Division of Pediatrics, Department of Medical and Surgical Sciences , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - Francesca Cipriani
- b Division of Pediatrics, Department of Medical and Surgical Sciences , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - Giulia Maria Ravaioli
- a Dermatology, Department of Experimental, Diagnostic and Specialty Medicine , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
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11
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Barnes TM, Greive KA. Topical pine tar: History, properties and use as a treatment for common skin conditions. Australas J Dermatol 2016; 58:80-85. [PMID: 26790564 PMCID: PMC5434829 DOI: 10.1111/ajd.12427] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 10/25/2015] [Indexed: 11/28/2022]
Abstract
Pine tar is the end product of pine wood carbonisation following distillation using extreme heat. An extensive literature search was conducted back to the 1950s for this review. Pine tar has been used in medicine for more than 2000 years to treat a range of skin conditions because of its soothing and antiseptic properties. Pine tar should not be confused with coal tar, which has been produced from coal for approximately a hundred years. Pine tar is thought to exert its effect by reducing DNA synthesis and mitotic activity, which promotes a return to normal keratinisation. In addition, pine tar has been shown to be antipruritic, anti‐inflammatory, antibacterial and antifungal. These properties make pine tar suitable for the topical treatment of eczema, psoriasis, seborrhoeic dermatitis and other dry, itchy, flaky or inflamed skin conditions. Topical products available over‐the‐counter in Australia today contain up to 2.3% pine tar, and come in several different formulations that can be used on the entire body, including the face. Modern day pine tar is manufactured with increased purity to eliminate toxic phenol and carcinogenic components, which have been of concern in the past. Primary irritation is uncommon. In conclusion, the long experience with topical pine tar therapy and its worldwide usage, together with the evidence presented in this review, suggests that pine tar is an effective treatment with minimal safety risk.
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Abstract
Genus Malassezia comprises of 14 species of “yeast like fungi,” 13 of which are lipophilic and 1 is nonlipophilic. They are known commensals and in predisposed individuals they commonly cause a spectrum of chronic recurrent infections. They rarely also cause serious illnesses like catheter-related blood stream infections, CAPD associated peritonitis etc., Though these fungi have been known to man for over 150 years, their fastidious nature and cumbersome culture and speciation techniques have restricted research. Since the last taxonomic revision, seven new species have been added to this genus. Their ability to evade the host immune system and virulence has increased the spectrum of the diseases caused by them. These agents have been implicated as causal agents in common diseases like atopic dermatitis recently. Though culture-based research is difficult, the new molecular analysis techniques and facilities have increased research in this field such that we can devote more attention to this genus to study in detail, their characteristics and their growing implications implications in the clinical scenario.
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Affiliation(s)
| | - Anupma Jyoti Kindo
- Department of Microbiology, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
| | - Mahalakshmi Veeraraghavan
- Department of Dermatology and Venereology, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
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Lian CH, Shen LL, Gao QY, Jiang M, Zhao ZJ, Zhao JJ. Identification of Malassezia species in the facial lesions of Chinese seborrhoeic dermatitis patients based on DNA sequencing. Mycoses 2014; 57:759-64. [PMID: 25124656 DOI: 10.1111/myc.12229] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 06/26/2014] [Accepted: 07/29/2014] [Indexed: 11/29/2022]
Abstract
The genus Malassezia is important in the aetiology of facial seborrhoeic dermatitis (FSD), which is the most common clinical type. The purpose of this study was to analyse the distribution of Malassezia species in the facial lesions of Chinese seborrhoeic dermatitis (SD) patients and healthy individuals. Sixty-four isolates of Malassezia were isolated from FSD patients and 60 isolates from healthy individuals. Sequence analysis of the internal transcribed spacer (ITS) region was used to identify the isolates. The most frequently identified Malassezia species associated with FSD was M. furfur (76.56%), followed by M. sympodialis (12.50%) and M. japonica (9.38%). The most frequently isolated species in healthy individuals were M. furfur (61.67%), followed by M. sympodialis (25.00%), M. japonica (6.67%), M. globosa (3.33%), and M. obtusa (3.33%). Overall, our study revealed that while M. furfur is the predominant Malassezia species in Chinese SD patients, there is no significant difference in the distribution of Malassezia species between Chinese SD patients and healthy individuals.
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Affiliation(s)
- C-h Lian
- Department of Dermatology, Shenzhen Second People's Hospital, Shenzhen, China
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Abstract
The immunopathology of AD is still unclear, but evidence for an immune response polarized towards Th2 activity has been provided. The CD30 molecule belongs to the tumour necrosis factor (TNF) receptor family and is expressed on activated T cells with a sustained expression in Th2 cells. This molecule also exists in a soluble form (sCD30). Elevated serum levels of sCD30 have been found in patients with Hodgkin's disease, chronic hepatitis B infection and HIV infection. Studies were undertaken to compare the serum levels of sCD30 in patients with AD (n=49) and healthy non-atopic controls (n=94). The presence of sCD30 was analysed with ELISA. A significantly higher concentration of sCD30 was noted in AD patients, median sCD30 level 29 U/ml (range 1-708 U/ml), compared with healthy non-atopic controls (P<0.001), where the median level was 11 U/ml with a range of 1-1042 U/ml. No correlation was found between sCD30 levels and total serum IgE, or between the AD patients' SCORAD values and concentration of sCD30. sCD30 levels were also analysed in 20 AD patients, which during ketoconazole treatment had improved their clinical scores and reduced their serum IgE and eosinophil cationic protein levels. However, no significant decrease in sCD30 levels was noted after treatment. The results show that patients with AD have elevated levels of sCD30, but without correlation to total serum IgE or disease activity.
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Affiliation(s)
- A Bengtsson
- Department of Laboratory Medicine, Karolinska Hospital and Institute, Stockholm, Sweden
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