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Rousel J, Nădăban A, Saghari M, Pagan L, Zhuparris A, Theelen B, Gambrah T, van der Wall HEC, Vreeken RJ, Feiss GL, Niemeyer-van der Kolk T, Burggraaf J, van Doorn MBA, Bouwstra JA, Rissmann R. Lesional skin of seborrheic dermatitis patients is characterized by skin barrier dysfunction and correlating alterations in the stratum corneum ceramide composition. Exp Dermatol 2024; 33:e14952. [PMID: 37974545 DOI: 10.1111/exd.14952] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/21/2023] [Accepted: 10/01/2023] [Indexed: 11/19/2023]
Abstract
Seborrheic dermatitis (SD) is a chronic inflammatory skin disease characterized by erythematous papulosquamous lesions in sebum rich areas such as the face and scalp. Its pathogenesis appears multifactorial with a disbalanced immune system, Malassezia driven microbial involvement and skin barrier perturbations. Microbial involvement has been well described in SD, but skin barrier involvement remains to be properly elucidated. To determine whether barrier impairment is a critical factor of inflammation in SD alongside microbial dysbiosis, a cross-sectional study was performed in 37 patients with mild-to-moderate facial SD. Their lesional and non-lesional skin was comprehensively and non-invasively assessed with standardized 2D-photography, optical coherence tomography (OCT), microbial profiling including Malassezia species identification, functional skin barrier assessments and ceramide profiling. The presence of inflammation was established through significant increases in erythema, epidermal thickness, vascularization and superficial roughness in lesional skin compared to non-lesional skin. Lesional skin showed a perturbed skin barrier with an underlying skewed ceramide subclass composition, impaired chain elongation and increased chain unsaturation. Changes in ceramide composition correlated with barrier impairment indicating interdependency of the functional barrier and ceramide composition. Lesional skin showed significantly increased Staphylococcus and decreased Cutibacterium abundances but similar Malassezia abundances and mycobial composition compared to non-lesional skin. Principal component analysis highlighted barrier properties as main discriminating features. To conclude, SD is associated with skin barrier dysfunction and changes in the ceramide composition. No significant differences in the abundance of Malassezia were observed. Restoring the cutaneous barrier might be a valid therapeutic approach in the treatment of facial SD.
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Affiliation(s)
- Jannik Rousel
- Centre for Human Drug Research, Leiden, The Netherlands
- Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Andreea Nădăban
- Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Mahdi Saghari
- Centre for Human Drug Research, Leiden, The Netherlands
- Leiden University Medical Center, Leiden, The Netherlands
| | - Lisa Pagan
- Centre for Human Drug Research, Leiden, The Netherlands
- Leiden University Medical Center, Leiden, The Netherlands
| | - Ahnjili Zhuparris
- Centre for Human Drug Research, Leiden, The Netherlands
- Leiden University Medical Center, Leiden, The Netherlands
- Leiden Institute of Advanced Computer Science, Leiden University, Leiden, Netherlands
| | - Bart Theelen
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Tom Gambrah
- Centre for Human Drug Research, Leiden, The Netherlands
| | | | - Rob J Vreeken
- Maastricht Multimodal Molecular Imaging Institute, Maastricht University, Maastricht, The Netherlands
| | | | | | - Jacobus Burggraaf
- Centre for Human Drug Research, Leiden, The Netherlands
- Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
- Leiden University Medical Center, Leiden, The Netherlands
| | - Martijn B A van Doorn
- Centre for Human Drug Research, Leiden, The Netherlands
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Joke A Bouwstra
- Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Robert Rissmann
- Centre for Human Drug Research, Leiden, The Netherlands
- Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
- Leiden University Medical Center, Leiden, The Netherlands
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