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Polaskey MT, Chang CH, Daftary K, Fakhraie S, Miller CH, Chovatiya R. The Global Prevalence of Seborrheic Dermatitis: A Systematic Review and Meta-Analysis. JAMA Dermatol 2024:2820685. [PMID: 38958996 PMCID: PMC11223058 DOI: 10.1001/jamadermatol.2024.1987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/05/2024] [Indexed: 07/04/2024]
Abstract
Importance Seborrheic dermatitis is a prevalent chronic inflammatory skin disease, yet its global prevalence, pathogenesis, and epidemiology remain inadequately defined. Objective To provide a detailed estimation of the global prevalence of seborrheic dermatitis, analyze demographic variations, and explore differences in various settings. Data Sources Embase, PubMed, Scopus, and Cochrane Database of Systematic Reviews were searched from inception through October 2023. Study Selection Original investigations on seborrheic dermatitis prevalence were included after duplicate screening of titles, abstracts, and full articles, including only studies with clinician-diagnosed cases. Data Extraction and Synthesis Following PRISMA guidelines, data were extracted and quality was assessed independently by multiple reviewers. A random-effects model using restricted maximum likelihood was used for meta-analysis and subgroup analyses. Main Outcome and Measure The primary outcome was the pooled estimate of global seborrheic dermatitis prevalence. Results From 1574 identified articles, 121 studies were included, encompassing 1 260 163 individuals and revealing a pooled global seborrheic dermatitis prevalence of 4.38% (95% CI, 3.58%-5.17%), with significant heterogeneity (I2 = 99.94%). Subgroup analyses showed variations by age, with a higher prevalence in adults (5.64% [95% CI, 4.01%-7.27%]) compared to children (3.70% [95% CI, 2.69%-4.80%]) and neonates (0.23% [95% CI, 0.04%-0.43%]). Geographic analyses indicated variability, with the highest prevalence in South Africa (8.82% [95% CI, 3.00%-14.64%]) and the lowest in India (2.62% [95% CI, 1.33%-3.92%]). Conclusions and Relevance This comprehensive meta-analysis provides a detailed estimation of the global prevalence of seborrheic dermatitis, highlighting significant variability across different demographics and settings.
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Affiliation(s)
- Meredith Tyree Polaskey
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago, Illinois
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Karishma Daftary
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Sheiva Fakhraie
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Corinne H. Miller
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Raj Chovatiya
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago, Illinois
- Center for Medical Dermatology and Immunology Research, Chicago, Illinois
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Blauvelt A, Draelos ZD, Stein Gold L, Alonso-Llamazares J, Bhatia N, DuBois J, Forman SB, Gooderham M, Green L, Guenthner ST, Hebert AA, Lain E, Moore AY, Papp KA, Zirwas M, Kato S, Snyder S, Krupa D, Burnett P, Berk DR, Chu DH. Roflumilast foam 0.3% for adolescent and adult patients with seborrheic dermatitis: A randomized, double-blinded, vehicle-controlled, phase 3 trial. J Am Acad Dermatol 2024; 90:986-993. [PMID: 38253129 DOI: 10.1016/j.jaad.2023.12.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/20/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND The topical phosphodiesterase 4 inhibitor roflumilast has been studied in several dermatologic conditions. OBJECTIVE Roflumilast foam 0.3% is being investigated as a topical treatment for seborrheic dermatitis (SD). METHODS In this phase 3, double-blinded trial, patients with SD were randomly assigned (2:1 ratio) to once-daily roflumilast foam 0.3% or vehicle foam for 8 weeks. The primary efficacy outcome was Investigator Global Assessment (IGA) Success at week 8, defined as IGA of 0 (Clear) or 1 (Almost Clear) plus ≥2-point improvement from baseline. Safety was also assessed. RESULTS 79.5% of roflumilast-treated and 58.0% of vehicle-treated patients met the primary endpoint (P < .001); statistically significant differences in IGA Success also favored roflumilast at week 2 (roflumilast: 43.0%; vehicle: 25.7%; P < .001) and week 4 (roflumilast: 73.1%; vehicle: 47.1%; P < .001). Roflumilast was well-tolerated with a low rate of treatment-emergent adverse events. LIMITATIONS Study limitations include the 8-week treatment period for this chronic condition. CONCLUSIONS Once-daily roflumilast foam was superior to vehicle in leading to IGA of Clear or Almost Clear plus ≥2-point improvement from baseline at 8 weeks in patients with SD. Longer trials are needed to determine durability and safety of roflumilast foam in SD.
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Affiliation(s)
| | - Zoe D Draelos
- Dermatology Consulting Services, High Point, North Carolina
| | | | | | - Neal Bhatia
- Therapeutics Clinical Research, San Diego, California
| | | | | | - Melinda Gooderham
- SKiN Centre for Dermatology, Probity Medical Research and Queen's University, Peterborough, Ontario, Canada
| | - Lawrence Green
- George Washington University School of Medicine, Rockville, Maryland
| | - Scott T Guenthner
- The Dermatology Center of Indiana, PC, Plainfield, Indiana; The Indiana Clinical Trials Center, PC, Plainfield, Indiana
| | | | | | - Angela Y Moore
- Arlington Research Center, Arlington, Texas; Baylor University Medical Center, Dallas, Texas
| | - Kim A Papp
- Probity Medical Research and Alliance Clinical Trials, Waterloo, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada
| | - Matthew Zirwas
- Dermatologists of the Central States, Cincinnati, Ohio; Probity Medical Research, Waterloo, Ontario, Canada; Ohio University, Bexley, Ohio
| | - Saori Kato
- Arcutis Biotherapeutics, Inc., Westlake Village, California
| | - Scott Snyder
- Arcutis Biotherapeutics, Inc., Westlake Village, California
| | - David Krupa
- Arcutis Biotherapeutics, Inc., Westlake Village, California
| | | | - David R Berk
- Arcutis Biotherapeutics, Inc., Westlake Village, California
| | - David H Chu
- Arcutis Biotherapeutics, Inc., Westlake Village, California
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Choi YG, Kim SY, Kim JS, Choi YJ, Kim WS. Efficacy and Safety of Precision Cryotherapy to Treat Seborrheic Dermatitis of the Scalp. Dermatol Surg 2024; 50:47-51. [PMID: 37788291 DOI: 10.1097/dss.0000000000003960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
BACKGROUND Recently, a new cryotherapy device that precisely controls skin temperature was developed. Precision cryotherapy (PC) can be a safe and alternative treatment modality for immune-related skin diseases that are difficult to treat by conventional cryotherapy because of serious adverse events. OBJECTIVE To evaluate the efficacy and safety of PC in scalp seborrheic dermatitis (SD). METHODS A single-arm, prospective trial was designed. Twenty-four patients with SD underwent 3 PC interventions 2 weeks apart. At the baseline, Week 6, and Week 8, overall improvements in Physician Global Assessment (PGA) and clinical severity scores were assessed. At each visit, the erythema index (EI) and transepidermal water loss were evaluated. The patients scored 9 subjective symptoms using a visual analog scale (VAS). RESULTS The itch VAS score decreased by 50.4% at Week 8. Blinded investigators reported improvement of PGA scores from 2.86 ± 0.62 to 1.66 ± 0.61 and clinical severity scores from 4.55 ± 1.30 to 2.45 ± 1.37. The average EI decreased by 19.6% at Week 8 ( p < .05). CONCLUSION This study not only demonstrated the efficacy and safety of PC in scalp SD but it also revealed insights for PC being a promising treatment modality in immune-related skin diseases.
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Affiliation(s)
- Yeon Gu Choi
- All authors are affiliated with the Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Muacevic A, Adler JR, Ghia D, Gandhi MR, Dhoot D, Barkate H. Prospective, Open-Label, Multi-Centre, Randomized Study to Compare the Effectiveness, Safety, and Tolerability of Lulican™ Shampoo Versus Ketoconazole Shampoo in Indian Adult Patients With Mild to Moderate Scalp Seborrheic Dermatitis (LEAD Study). Cureus 2022; 14:e32035. [PMID: 36600812 PMCID: PMC9801137 DOI: 10.7759/cureus.32035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Although seborrheic dermatitis (SD) is not lethal, it has a significant impact on the quality of life. Many cases of SD are managed with ketoconazole, but luliconazole has shown an equivalent or lower minimum inhibitory concentration (MIC), but not many studies have been done for its efficacy and safety in SD. With this in mind, we set out to conduct a study comparing the effectiveness, safety, and tolerability of Lulican™ (luliconazole 1% + salicylic acid 3% + ZPTO 1%) shampoo and Ketoconazole (Ketoconazole 2% + ZPTO 1%) shampoo in the treatment of SD. Materials and methods In this prospective, randomized, multi-center study, mild to moderate scalp SD patients were prescribed Lulican™ or Ketoconazole shampoo three times a week for a duration of four weeks. Effectiveness assessment was done with the Seborrheic-Dermatitis-Severity-Score (SDSS) and Physician-Global-Assessment (PGA), and quality of life was assessed with the help of the Scalpdex-23 questionnaire. Results At four weeks, 68% and 57.9% reduction was seen in SDSS in Lulican™ and Ketoconazole shampoo, respectively. Moreover, 58% and 44% of patients achieved excellent to moderate responses as per PGA with Lulican™ and ketoconazole shampoo, respectively. For safety, no statistical difference was reported, but product tolerability and subjective cosmetic acceptability were significantly better in the Lulican™ group as compared to the Ketoconazole group at the end of four weeks. The mean Scalpdex-23 score at week four was reduced by 35.7% and 21.1% in Lulican™ and ketoconazole groups, respectively (p<0.05). Conclusion While both treatments were successful in alleviating SD symptoms and were well tolerated, Lulican™ stood out as a preferred treatment option due to better quality of life (QoL) improvement in SD.
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Altan E, Karacelebi Y, Saatcioglu E, Ulag S, Sahin A, Aksu B, Croitoru AM, Codrea CI, Ficai D, Gunduz O, Ficai A. Fabrication of Electrospun Juglans regia (Juglone) Loaded Poly(lactic acid) Scaffolds as a Potential Wound Dressing Material. Polymers (Basel) 2022; 14:polym14101971. [PMID: 35631857 PMCID: PMC9143170 DOI: 10.3390/polym14101971] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/21/2022] [Accepted: 05/07/2022] [Indexed: 01/24/2023] Open
Abstract
Juglone (5-hydroxy-1,4-naphthoquinone) (J) is a naphthoquinone structured allelochemical that is mostly found in the roots, leaves, nut-hulls, bark, and wood of walnut (Juglans regia). In this study, the biocompatibility, mechanical, thermal, chemical, morphological, and antimicrobial properties of the poly(lactic acid) (PLA) (w/v)/J (10, 20, 30 mg) electrospun scaffolds were investigated. Based on the results of the study, it was shown that juglone addition increased the antimicrobial properties of the scaffolds against the Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli), compared to the neat PLA film after 24 h of contact time. According to the tensile test results, the addition of J made the scaffolds more flexible but decreased the mechanical strength. The cytotoxicity properties of the J-added scaffolds demonstrated a toxic behavior on the first day of incubation. However, with an increase in the J ratio, the fibroblast cell metabolic activity increased for all incubation periods.
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Affiliation(s)
- Eray Altan
- Center for Nanotechnology & Biomaterials Application and Research (NBUAM), Department of Metallurgical and Materials Engineering, Faculty of Technology, Marmara University, Istanbul 34722, Turkey; (E.A.); (E.S.)
| | - Yasin Karacelebi
- Center for Nanotechnology & Biomaterials Application and Research (NBUAM), Department of Bioengineering, Faculty of Engineering, Marmara University, Istanbul 34722, Turkey;
| | - Elif Saatcioglu
- Center for Nanotechnology & Biomaterials Application and Research (NBUAM), Department of Metallurgical and Materials Engineering, Faculty of Technology, Marmara University, Istanbul 34722, Turkey; (E.A.); (E.S.)
| | - Songul Ulag
- Center for Nanotechnology & Biomaterials Application and Research (NBUAM), Department of Metallurgical and Materials Engineering, Institute of Pure and Applied Sciences, Marmara University, Istanbul 34722, Turkey;
| | - Ali Sahin
- Department of Biochemistry, Faculty of Medicine, Marmara University, Istanbul 34722, Turkey;
| | - Burak Aksu
- Department of Medical Microbiology, Faculty of Medicine, Marmara University, Istanbul 34722, Turkey;
| | - Alexa-Maria Croitoru
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1–7 Gh Polizu Street, 060042 Bucharest, Romania; (A.-M.C.); (C.I.C.)
- National Centre for Micro and Nanomaterials, University Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania;
- National Centre for Food Safety, University Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
| | - Cosmin Iulian Codrea
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1–7 Gh Polizu Street, 060042 Bucharest, Romania; (A.-M.C.); (C.I.C.)
- National Centre for Micro and Nanomaterials, University Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania;
- National Centre for Food Safety, University Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
- “Ilie Murgulescu” Institute of Physical Chemistry, Romanian Academy, 202 Splaiul Independentei, 060021 Bucharest, Romania
| | - Denisa Ficai
- National Centre for Micro and Nanomaterials, University Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania;
- National Centre for Food Safety, University Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
- Department of Inorganic Chemistry, Physical Chemistry and Electrochemistry, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1–7 Gh Polizu Street, 060042 Bucharest, Romania
| | - Oguzhan Gunduz
- Center for Nanotechnology & Biomaterials Application and Research (NBUAM), Department of Metallurgical and Materials Engineering, Faculty of Technology, Marmara University, Istanbul 34722, Turkey; (E.A.); (E.S.)
- Correspondence: (O.G.); (A.F.)
| | - Anton Ficai
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1–7 Gh Polizu Street, 060042 Bucharest, Romania; (A.-M.C.); (C.I.C.)
- National Centre for Micro and Nanomaterials, University Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania;
- National Centre for Food Safety, University Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
- Academy of Romanian Scientists, Ilfov St. 3, 50044 Bucharest, Romania
- Correspondence: (O.G.); (A.F.)
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Krajewski PK, Tyczyńska K, Bardowska K, Olczyk P, Krajewska M, Szepietowski JC. Psychosocial Burden of Itch among Renal Transplant Recipients. Toxins (Basel) 2022; 14:320. [PMID: 35622567 PMCID: PMC9145006 DOI: 10.3390/toxins14050320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 12/10/2022] Open
Abstract
Itch is the most common symptom of chronic dermatoses. Moreover, itch may be associated with systemic disorders. Chronic kidney disease—associated itch (CKD-aI) may affect up to 20% of renal transplant recipients (RTR). The aim of the study was to assess psychosocial burden of itch in RTR. The study was performed on a group of 129 RTR, out of which 54 (41.9%) experienced itch in the previous 3 days. A specially designed questionnaire assessing anxiety, depression, stigmatization, and quality of life was used. Results: Patients suffering from itch in the previous 3 days achieved significantly higher scores in GAD-7 (p < 0.001), BDI (p < 0.001), HADS total score (p < 0.001), HADS Depression (p = 0.004), and HADS Anxiety (p < 0.001). Severity of itch correlated positively with HADS, stigmatization scale, and GAD-7. Itch in RTR was associated with higher incidence of depression assessed with BDI (OR 3.7). Moreover, higher prevalence of anxiety was found among patients suffering from CKD-aI, assessed with HADS A and GAD-7 (OR 2.7 and OR 4.8, respectively) The results of our study clearly demonstrate that itch among RTR is a significant burden. Higher prevalence of depression and anxiety in this groups indicate the necessity of addressing itch relief as a part of holistic approach to patients after renal transplantation.
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Affiliation(s)
- Piotr K. Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (P.K.K.); (K.T.); (K.B.)
| | - Kinga Tyczyńska
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (P.K.K.); (K.T.); (K.B.)
| | - Klaudia Bardowska
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (P.K.K.); (K.T.); (K.B.)
| | - Piotr Olczyk
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-368 Wroclaw, Poland; (P.O.); (M.K.)
| | - Magdalena Krajewska
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-368 Wroclaw, Poland; (P.O.); (M.K.)
| | - Jacek C. Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (P.K.K.); (K.T.); (K.B.)
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Niemann N, Billnitzer A, Jankovic J. Parkinson's disease and skin. Parkinsonism Relat Disord 2020; 82:61-76. [PMID: 33248395 DOI: 10.1016/j.parkreldis.2020.11.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/18/2020] [Accepted: 11/17/2020] [Indexed: 12/11/2022]
Abstract
Parkinson's disease is associated with a variety of dermatologic disorders and the study of skin may provide insights into pathophysiological mechanisms underlying this common neurodegenerative disorder. Skin disorders in patients with Parkinson's disease can be divided into two major groups: 1) non-iatrogenic disorders, including melanoma, seborrheic dermatitis, sweating disorders, bullous pemphigoid, and rosacea, and 2) iatrogenic disorders related either to systemic side effects of antiparkinsonian medications or to the delivery system of antiparkinsonian therapy, including primarily carbidopa/levodopa, rotigotine and other dopamine agonists, amantadine, catechol-O-methyl transferase inhibitors, subcutaneous apomorphine, levodopa/carbidopa intestinal gel, and deep brain stimulation. Recent advances in our understanding of the role of α-synuclein in peripheral tissues, including the skin, and research based on induced pluripotent stem cells derived from skin fibroblasts have made skin an important target for the study of Parkinson's disease pathogenesis, drug discovery, novel stem cell therapies, and diagnostics.
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Affiliation(s)
- Nicki Niemann
- Muhammad Ali Parkinson Center, Department of Neurology, Barrow Neurological Institute, Phoenix, AZ, USA.
| | - Andrew Billnitzer
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
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Tacrolimus 0.1% versus ciclopiroxolamine 1% for maintenance therapy in patients with severe facial seborrheic dermatitis: A multicenter, double-blind, randomized controlled study. J Am Acad Dermatol 2020; 84:1278-1284. [PMID: 33010323 DOI: 10.1016/j.jaad.2020.09.055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND No long-term maintenance therapy has been tested in patients with seborrheic dermatitis (SD). OBJECTIVE We sought to compare the efficacy and tolerance of tacrolimus 0.1% ointment versus ciclopiroxolamine 1% cream as maintenance therapy for severe SD. METHODS This double-blind randomized controlled study was conducted from 2014 to 2017 in 5 Dermatology Departments and 15 dermatology practices in France. Consecutive patients with severe and chronic facial SD were included. Patients were initially treated with desonide 0.05% cream twice daily for 7 days. Patients cleared after this open phase were randomized to receive tacrolimus 0.1% or ciclopiroxolamine 1% cream 2 times a week 24 weeks. The primary endpoint was disease-free-duration, defined as the time from randomization to first relapse. RESULTS One hundred fourteen patients were randomized (tacrolimus, n = 57; ciclopiroxolamine, n = 57). Twelve patients relapsed in the tacrolimus group after a median delay of 91.5 days (range 15-195 days) versus 23 patients in the ciclopiroxolamine group (median delay, 27 days [range 13-201 days]). Comparison of disease-free duration curves showed that patients in the tacrolimus group had a longer duration of complete remission than those in the ciclopiroxolamine group (P = .018), corresponding to a hazard ratio of relapse of 0.44 (95% confidence interval 0.22-0.89; P = .022). LIMITATIONS The theoretical sample size was not reached. CONCLUSION Tacrolimus 0.1% is more effective than ciclopiroxolamine 1% as maintenance therapy for patients with facial SD.
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Xuan M, Lu C, He Z. Clinical characteristics and quality of life in seborrheic dermatitis patients: a cross-sectional study in China. Health Qual Life Outcomes 2020; 18:308. [PMID: 32938485 PMCID: PMC7493366 DOI: 10.1186/s12955-020-01558-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/09/2020] [Indexed: 11/11/2022] Open
Abstract
Background Seborrheic dermatitis (SD) is a common, chronic, inflammatory skin disorder, yet few studies have reported its clinical characteristics, or addressed its effect on quality of life (QoL). This study assesses the clinical characteristics and QoL of SD patients in China. It also identifies the clinical, demographic and environmental factors that may influence QoL. Methods Three hundred twelve SD outpatients from 9 hospitals completed a survey. QoL was measured with the dermatology-specific instrument Skindex-29. We collected social demographic characteristics and disease severity, and conducted logistic regression to determine the factors associated with QoL impairment. Results 67.3% of the patients were females. The mean Skindex-29 overall score was 33.97 (SD = 20.55). The breakdown was 40.79 (SD = 24.24) for emotions, 32.83 (SD = 19.84) for symptoms and 28.3 (SD = 23.24) for functioning. 48.1% had severe emotional problems. Logistic regression analysis showed that BMI less than 25 (OR = 0.223; 95% CI: 0.072–0.692; P = 0.009), skin disease-related hospitalization (OR = 6.882; 95% CI:1.767–26.795; P = 0.005), environmental PM 10 levels above 120 μg/m3 (OR = 3.386; 95% CI: 1.253–9.15; P = 0.016) and severe disease conditions (OR = 4.438; 95% CI:1.26–15.626; P = 0.02) were risk factors for severe emotional impairment. Moreover, skin disease-related hospitalization (OR = 6.057; 95% CI:1.351–27.149; P = 0.019), environmental PM 10 levels between 70 and 120 μg/m3 (OR = 6.317; 94% CI: 1.704–23.42; P = 0.006), moderate (OR = 2.388; 95% CI: 1.272–4.487; P = 0.007) and severe disease conditions (OR = 5.732; 95% CI: 1.838–17.88; P = 0.003) were each risk factors for overall severe impairment. Conclusion In China, nearly half of SD patients had severely emotional problems. Disease severity, BMI, dermatologic hospitalization, and ambient PM 10 levels are each risk factors for QoL impairment in SD patients. These implications are alarming, and warrant public health attention in SD disease management.
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Affiliation(s)
- Meiling Xuan
- Key Unit of Methodology in Clinical Research, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.,State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Chuanjian Lu
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China. .,Department of Dermatology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China. .,Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
| | - Zehui He
- Department of Clinical Epidemiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No.111 Da De Road, Yue Xiu District, Guangzhou, 510120, Guangdong, China.
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Dos Santos DS, Barreto RDSS, Serafini MR, Gouveia DN, Marques RS, Nascimento LDC, Nascimento JDC, Guimarães AG. Phytomedicines containing Matricaria species for the treatment of skin diseases: A biotechnological approach. Fitoterapia 2019; 138:104267. [PMID: 31319107 DOI: 10.1016/j.fitote.2019.104267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/11/2019] [Accepted: 07/12/2019] [Indexed: 01/09/2023]
Abstract
Skin diseases have a notable impact on the life of the affected and in their health conditions. In order to allow a more effective and economical treatment for such disorders, new therapeutic approaches have been continuously investigated. Due to its high therapeutic and phytochemical potential, Matricaria species emerges as a pleasant alternative, since it is an important source of bioactive secondary metabolites suitable for the treatment of varied skin diseases. Therefore, this review aimed to catalog inventions that have used Matricaria species as the active component for skin disease treatment in order to assess the status of the technological development of the fitomedicines. For this, a search of patents was performed in four specialized patent database, which have reported the discovery of pharmaceutical bioproducts that used Matricaria species in its composition for skin treatment. Therefore, it is possible to notice that the pharmaceutical industry has driven efforts and investment to produce medicines for the dermatopathies, using species of this genus as an active principle. Besides, a trend of growth has been identified for the last years, which is accompanied by the continuous publication of scientific articles on the subject. It is known that a long journey is traversed between the scientific findings and their applications in the pharmaceutical market, creating the perspective that new Matricaria-based medicines may reach the pharmaceutical market in the coming years.
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Affiliation(s)
- Damaris Silva Dos Santos
- Programa de Pós-graduação em Ciências Aplicadas à Saúde, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil
| | - Rosana de Souza Siqueira Barreto
- Programa de Pós-graduação em Ciências Aplicadas à Saúde, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil; Departmento de Educação em Saúde, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil
| | - Mairim Russo Serafini
- Departmento de Farmácia, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil
| | - Daniele Nascimento Gouveia
- Programa de Pós-graduação em Ciências Aplicadas à Saúde, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil
| | - Raquel Souza Marques
- Programa de Pós-graduação em Ciências Odontológicas, Universidade do Estado de São Paulo, Araraquara, São Paulo, Brazil
| | | | | | - Adriana Gibara Guimarães
- Programa de Pós-graduação em Ciências Aplicadas à Saúde, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil; Departmento de Educação em Saúde, Universidade Federal de Sergipe, Lagarto, Sergipe, Brazil.
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11
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An Q, Sun M, Qi RQ, Zhang L, Zhai JL, Hong YX, Song B, Chen HD, Gao XH. High Staphylococcus epidermidis Colonization and Impaired Permeability Barrier in Facial Seborrheic Dermatitis. Chin Med J (Engl) 2018; 130:1662-1669. [PMID: 28685715 PMCID: PMC5520552 DOI: 10.4103/0366-6999.209895] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Seborrheic dermatitis (SD) is a common inflammatory skin condition. The etiology is unclear, although overgrowth of Malassezia on the skin has been suggested to cause SD. This study investigated whether colonization with Staphylococcus plays a role in facial SD, which was not well addressed previously. METHODS The study was conducted from September 1, 2011 to February 20, 2012 in the First Hospital of China Medical University. In the first phase, the study evaluated the level of transepidermal water loss (TEWL) and the number of colony-forming units (CFU) of Staphylococcus in defined skin areas of SD patients who were human immunodeficiency virus (HIV) seropositive (HIV [+] SD [+] group, n = 13), classical SD (HIV [-] SD [+] group, n = 24) patients, HIV seropositive-non-SD (HIV [+] SD [-] group, n = 16) patients, and healthy volunteers (HIV [-] SD [-] group, n = 16). In the second phase, we enrolled another cohort of HIV (-) SD (+) patients who applied topical fusidic acid (n = 15), tacrolimus (n = 16), or moisturizer (n = 12). Changes in the Seborrheic Dermatitis Area Severity Index (SDASI), TEWL, and Staphylococcus density were evaluated 2 weeks later. Comparisons of each index were performed using analysis of variance (ANOVA) and least significant difference method. RESULTS The level of TEWL was greater through lesional sites in the HIV (+) SD (+) group than that in HIV (+) SD (-) and HIV (-) SD (-) groups (95% confidence interval [CI]: 18.873-47.071, P < 0.001 and 95% CI: 28.755-55.936, P < 0.001, respectively). The number of CFU of Staphylococcus was greater in the HIV (+) SD (+) group than that in HIV (+) SD (-) and HIV (-) SD (-) groups (95% CI: 37.487-142.744, P = 0.001 and 95% CI: 54.936-156.400, P < 0.001, respectively). TEWL was significantly more improved in patients treated with tacrolimus and fusidic acid than that in those treated with moisturizers (95% CI: 7.560-38.987, P = 0.004 and 95% CI: 4.659-37.619, P = 0.011, respectively). Topical tacrolimus and fusidic acid were significantly associated with decreased SDASI as compared with moisturizer (95% CI: 0.03-0.432, P = 0.025 and 95% CI: 0.033-0.44, P = 0.024, respectively). CONCLUSIONS High colonization with Staphylococcus epidermidis, along with impaired skin permeability barrier function, contributes to the occurrence of SD.
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Affiliation(s)
- Qian An
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Meng Sun
- Department of Dermatology, Shenyang Children's Hospital, Shenyang, Liaoning 110032, China
| | - Rui-Qun Qi
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Li Zhang
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Jin-Long Zhai
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Yu-Xiao Hong
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Bing Song
- Department of Regenerative Medicine, Cardiff Institute of Tissue Engineering and Repair, School of Dentistry, Cardiff University, CF10 3AT, UK
| | - Hong-Duo Chen
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Xing-Hua Gao
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
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12
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Hur MS, Lee YW. Pharmacologic treatment of seborrheic dermatitis. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2017. [DOI: 10.5124/jkma.2017.60.5.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Min Seok Hur
- Department of Dermatology, Konkuk University School of Medicine, Seoul, Korea
| | - Yang Won Lee
- Department of Dermatology, Konkuk University School of Medicine, Seoul, Korea
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13
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Ekzemerkrankungen in der Adoleszenz. Hautarzt 2016; 67:287-92. [DOI: 10.1007/s00105-016-3764-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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BAŞ Y, SEÇKİN HY, KALKAN G, TAKCI Z, ÇITIL R, ÖNDER Y, ŞAHİN Ş, DEMİR AK. Prevalence and related factors of psoriasis and seborrheic dermatitis: a community-based study. Turk J Med Sci 2016; 46:303-9. [DOI: 10.3906/sag-1406-51] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 05/15/2015] [Indexed: 11/03/2022] Open
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15
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Validation of the Spanish Version of the Itch Severity Scale: The PSEDA Study. ACTAS DERMO-SIFILIOGRAFICAS 2011. [DOI: 10.1016/j.adengl.2011.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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16
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Validación de la versión española de la escala de intensidad del picor (Cuestionario Itch Severity Scale, ISS). Estudio PSEDA. ACTAS DERMO-SIFILIOGRAFICAS 2011; 102:527-36. [DOI: 10.1016/j.ad.2011.03.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Revised: 03/14/2011] [Accepted: 03/20/2011] [Indexed: 11/24/2022] Open
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17
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Cook BA, Warshaw EM. Role of topical calcineurin inhibitors in the treatment of seborrheic dermatitis: a review of pathophysiology, safety, and efficacy. Am J Clin Dermatol 2009; 10:103-18. [PMID: 19222250 DOI: 10.2165/00128071-200910020-00003] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Seborrheic dermatitis (SD) is characterized by erythematous pruritic patches and plaques with greasy scale that occur in sebaceous areas. It is common, affecting up to 3% of the population. Past treatments have relied on a wide variety of anti-inflammatory and antifungal agents, but corticosteroids have limited use because of long-term adverse effects. Topical calcineurin inhibitors provide a safe alternative for the treatment of SD, as these drugs block the inflammatory cascade involved in the disease process and pose no risk of skin atrophy. Studies of topical pimecrolimus and tacrolimus in the treatment of SD have found that improvement occurred within 2 weeks, and if SD recurred after stopping treatment, it was significantly less severe. There have been no studies of the comparative efficacy of pimecrolimus versus tacrolimus for the treatment of SD. Common adverse effects of mild burning and irritation have been associated with the use of both of these agents. Safety profile studies are limited to studies of atopic dermatitis, which show no increase in infection rate, photocarcinogenicity, or signs of immunosuppression in patients using topical calcineurin inhibitors for long-term treatment. This article reviews the clinical trials of pimecrolimus and tacrolimus in the treatment of SD, focusing on efficacy and safety.
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Affiliation(s)
- Bethany A Cook
- University of Minnesota School of Medicine, Minneapolis, Minnesota, USA
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