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Veasey JV, Carvalho GDSM, Valinoto GCJ. Oral isotretinoin for the treatment of chronic pityriasis versicolor: case report and literature review. An Bras Dermatol 2024; 99:639-642. [PMID: 38670865 PMCID: PMC11221268 DOI: 10.1016/j.abd.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 08/16/2023] [Accepted: 08/25/2023] [Indexed: 04/28/2024] Open
Affiliation(s)
- John Verrinder Veasey
- Dermatology Clinic, Hospital da Santa Casa de São Paulo, São Paulo, SP, Brazil; Discipline of Dermatology, Santa Casa de São Paulo School of Medical Sciences, São Paulo, SP, Brazil.
| | - Gustavo de Sá Menezes Carvalho
- Dermatology Clinic, Hospital da Santa Casa de São Paulo, São Paulo, SP, Brazil; Discipline of Dermatology, Santa Casa de São Paulo School of Medical Sciences, São Paulo, SP, Brazil
| | - Guilherme Camargo Julio Valinoto
- Dermatology Clinic, Hospital da Santa Casa de São Paulo, São Paulo, SP, Brazil; Discipline of Dermatology, Santa Casa de São Paulo School of Medical Sciences, São Paulo, SP, Brazil
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Jackson JM, Alexis A, Zirwas M, Taylor S. Unmet needs for patients with seborrheic dermatitis. J Am Acad Dermatol 2024; 90:597-604. [PMID: 36538948 DOI: 10.1016/j.jaad.2022.12.017] [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: 06/21/2022] [Revised: 12/07/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Abstract
Seborrheic dermatitis (SD) is a common skin disease with signs and symptoms that may vary by skin color, associated medical conditions, environmental factors, and vehicle preference. Diagnosis of SD is based on presence of flaky, "greasy" patches, and/or thin plaques accompanied by erythema of the scalp, face, ears, chest, and groin and is associated with pruritus in many patients. The presentation may vary in different skin types and hyper- or hypopigmentation may occur, with or without erythema and minimal or no scaling. While the pathogenesis is not certain, 3 key factors generally agreed upon include lipid secretion by sebaceous glands, Malassezia spp. colonization, and some form of immunologic dysregulation that predisposes the patient to SD. Treatment involves reducing proliferation of, and inflammatory response to, Malassezia spp. Topical therapies, including antifungal agents and low potency corticosteroids, are the mainstay of treatment but may be limited by efficacy and side effects. Few novel treatments for SD are currently being studied; however, clinical trials assessing the use of topical phosphodiesterase-4 inhibitors have been completed. Improving outcomes in SD requires recognizing patient-specific manifestations/locations of the disease, including increased awareness of how it affects people of all skin types.
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Affiliation(s)
- J Mark Jackson
- University of Louisville, Division of Dermatology, Forefront Dermatology, Louisville, Kentucky.
| | | | - Matthew Zirwas
- Dermatologists of the Central States, Probity Medical Research, and Ohio University, Bexley, Ohio
| | - Susan Taylor
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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de Jesus GFA, Rossetto MP, Voytena A, Feder B, Borges H, da Costa Borges G, Feuser ZP, Dal-Bó S, Michels M. Clinical evaluation of paraprobiotic-associated Bifidobacterium lactis CCT 7858 anti-dandruff shampoo efficacy: A randomized placebo-controlled clinical trial. Int J Cosmet Sci 2023; 45:572-580. [PMID: 36862071 DOI: 10.1111/ics.12850] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/22/2022] [Accepted: 02/21/2023] [Indexed: 03/03/2023]
Abstract
OBJECTIVE The microbiome plays an important role in a wide variety of skin disorders. Hence, dysbiosis in the skin and/or gut microbiome is associated with an altered immune response, promoting the development of skin diseases, such as atopic dermatitis, psoriasis, acne vulgaris and dandruff. Studies have shown that paraprobiotics may be promising for the treatment of skin disorders through microbiota modulation and immunomodulation. So, the objective is to develop an anti-dandruff formulation using a paraprobiotic (Neoimuno) as active ingredient. METHODS Randomized, double-blind, placebo-controlled clinical trial was performed in patients who had any degree of dandruff. A total of 33 volunteers were recruited and randomly divided into two groups: placebo or treated. (1% Neoimuno). The ingredient used was Neoimuno (Bifidobacterium lactis strain CCT 7858). Combability analysis and perception questionnaire were applied before and after treatment. Statistical analyses were performed. RESULTS No adverse effects were reported by patients throughout the study. Through the combability analysis, a significant decrease in the number of particles was verified after 28 days of shampoo use. Regarding perception, there was a significant difference for the cleaning variables and improvement of the general appearance 28 days after the intervention. There were no significant differences for the itching and scaling parameters, as well as the perception parameters at 14 days. DISCUSSION Topical application of the paraprobiotic shampoo containing 1% Neoimuno was able to significantly improve the feeling of cleanliness and general aspects of dandruff, in addition to reducing scalp flakiness. Thus, with the results obtained through the clinical trial, Neoimuno presents itself as a natural, safe and effective ingredient in the treatment of dandruff. The efficacy of Neoimuno in dandruff was visible within 4 weeks.
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Affiliation(s)
| | - Marina Piola Rossetto
- BioHall Consultoria, Pesquisa e Inovação, Itajai, Santa Catarina, Brazil
- Gabbia Biotechnology, Itajai, Santa Catarina, Brazil
| | - Ana Voytena
- Gabbia Biotechnology, Itajai, Santa Catarina, Brazil
| | - Bianca Feder
- BioHall Consultoria, Pesquisa e Inovação, Itajai, Santa Catarina, Brazil
| | - Heloisa Borges
- Undergraduate Pharmacy Course, University of Southern Santa Catarina (UNESC), Criciuma, Brazil
| | - Gabriel da Costa Borges
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciuma, Brazil
| | - Zoé Paulina Feuser
- Undergraduate Pharmacy Course, University of Southern Santa Catarina (UNESC), Criciuma, Brazil
| | - Silvia Dal-Bó
- Undergraduate Pharmacy Course, University of Southern Santa Catarina (UNESC), Criciuma, Brazil
| | - Monique Michels
- BioHall Consultoria, Pesquisa e Inovação, Itajai, Santa Catarina, Brazil
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Alsmeirat O, Lakhani S, Egaimi M, Idris O, Elkhalifa M. The Efficacy and Safety of Pimecrolimus in Patients With Facial Seborrheic Dermatitis: A Systematic Review of Randomized Controlled Trials. Cureus 2022; 14:e27622. [PMID: 36072203 PMCID: PMC9436712 DOI: 10.7759/cureus.27622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2022] [Indexed: 11/05/2022] Open
Abstract
Facial seborrheic dermatitis (SD) is a chronic inflammatory skin condition that can affect the quality of life with frequent recurrences. There is no medication as yet to cure this disease completely. There are four general categories of agents that are used to treat SD: antifungal agents, keratolytics, corticosteroids, and lastly calcineurin inhibitors. Topical therapies are the mainstream line of treatment to be used for this skin condition. The objective of this article is to critically review the published data in the literature on the use of topical pimecrolimus 1% topical cream as an option for treating facial SD. The final purpose of this review is to answer two questions: whether pimecrolimus topical cream is effective for the treatment of SD compared to the conventional current treatments and how safe is this treatment. The PubMed, Clinicaltrials.gov, MEDLINE + Embase, and Cochrane library databases were searched for original randomized clinical trials (RCTs) evaluating pimecrolimus 1% topical cream and comparing it with other topical treatments for SD. A systematic review and meta-analysis were then conducted on the selected studies by grading the evidence and qualitative comparison of results among and within studies. A total of five studies were included in the review; however, only four were eligible for inclusion in the meta-analysis, in which pimecrolimus was compared with other treatments for the management of facial SD. Pimecrolimus was found to be an effective topical treatment for facial SD, as it showed considerable desirable control of the symptoms in patients with facial SD clinically, in addition to a lower recurrence or relapsing rates; however, it had more side effects compared to other topical treatments, but the side effects were mild and tolerable.
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Hobi S, Cafarchia C, Romano V, Barrs VR. Malassezia: Zoonotic Implications, Parallels and Differences in Colonization and Disease in Humans and Animals. J Fungi (Basel) 2022; 8:jof8070708. [PMID: 35887463 PMCID: PMC9324274 DOI: 10.3390/jof8070708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 12/13/2022] Open
Abstract
Malassezia spp. are commensals of the skin, oral/sinonasal cavity, lower respiratory and gastrointestinal tract. Eighteen species have been recovered from humans, other mammals and birds. They can also be isolated from diverse environments, suggesting an evolutionary trajectory of adaption from an ecological niche in plants and soil to the mucocutaneous ecosystem of warm-blooded vertebrates. In humans, dogs and cats, Malassezia-associated dermatological conditions share some commonalities. Otomycosis is common in companion animals but is rare in humans. Systemic infections, which are increasingly reported in humans, have yet to be recognized in animals. Malassezia species have also been identified as pathogenetic contributors to some chronic human diseases. While Malassezia species are host-adapted, some species are zoophilic and can cause fungemia, with outbreaks in neonatal intensive care wards associated with temporary colonization of healthcare worker’s hands from contact with their pets. Although standardization is lacking, susceptibility testing is usually performed using a modified broth microdilution method. Antifungal susceptibility can vary depending on Malassezia species, body location, infection type, disease duration, presence of co-morbidities and immunosuppression. Antifungal resistance mechanisms include biofilm formation, mutations or overexpression of ERG11, overexpression of efflux pumps and gene rearrangements or overexpression in chromosome 4.
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Affiliation(s)
- Stefan Hobi
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University, Tat Chee Avenue, Kowloon, Hong Kong, China
- Correspondence: (S.H.); (V.R.B.)
| | - Claudia Cafarchia
- Department of Veterinary Medicine, University of Bari, Str. prov. per Casamassima Km 3, Valenzano, (Bari), 70010, Italy; (C.C.); (V.R.)
| | - Valentina Romano
- Department of Veterinary Medicine, University of Bari, Str. prov. per Casamassima Km 3, Valenzano, (Bari), 70010, Italy; (C.C.); (V.R.)
| | - Vanessa R. Barrs
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University, Tat Chee Avenue, Kowloon, Hong Kong, China
- Centre for Animal Health and Welfare, City University of Hong Kong, Kowloon Tong, Hong Kong, China
- Correspondence: (S.H.); (V.R.B.)
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Massiot P, Clavaud C, Thomas M, Ott A, Guéniche A, Panhard S, Muller B, Michelin C, Kerob D, Bouloc A, Reygagne P. Continuous clinical improvement of mild-to-moderate seborrheic dermatitis and rebalancing of the scalp microbiome using a selenium disulfide-based shampoo after an initial treatment with ketoconazole. J Cosmet Dermatol 2021; 21:2215-2225. [PMID: 34416081 DOI: 10.1111/jocd.14362] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/24/2021] [Accepted: 07/22/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Scalp seborrheic dermatitis (SD) is a chronic, relapsing, and inflammatory scalp disease. Studies indicate a global bacterial and fungal microbiota shift of scalp SD, as compared to healthy scalp. Ketoconazole and selenium disulfide (SeS2 ) improve clinical signs and symptoms in both scalp dandruff and SD. AIM The main objective of this study was to investigate the changes in the scalp microbiota diversity and counts in subjects with scalp SD during a two-phase treatment period. MATERIAL AND METHODS The scalp microbiota and clinical efficacy were investigated in 68 subjects with mild-to-moderate scalp SD after an initial one-month treatment with 2% ketoconazole, and after a 2-month maintenance phase, either with a 1% SeS2 -based shampoo or its vehicle. RESULTS Thirty one subjects in the active and 37 subjects in the vehicle group participated. Ketoconazole provided an improvement of clinical symptoms (adherent (-1.75 p < 0.05), non-adherent (-1.5, p < 0.05)) flakes and erythema (scores 1.67-0.93, p < 0.001), in an increased fungal diversity and in a significant (p < 0.005) decrease of Malassezia spp. SeS2 provided an additional clinical improvement (-0.8; p = 0.0002 and -0.7; p = 0.0081 for adherent and non-adherent flakes, respectively, at Day 84) compared to the vehicle associated with a low Malassezia spp. count and an additional significant (p < 0.001) decrease of the Staphylococcus spp. level. CONCLUSION Selenium disulfide provides an additional benefit on the scalp microbiota and in clinical symptoms of SD and dandruff after treatment with ketoconazole. The results confirm the role of Staphylococcus spp. in scalp SD and open possible perspectives for preventing relapses.
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Affiliation(s)
| | | | - Marie Thomas
- L'Oréal Research & Innovation, Aulnay-sous-Bois, France
| | - Alban Ott
- L'Oréal Research & Innovation, Aulnay-sous-Bois, France
| | | | | | | | | | | | - Anne Bouloc
- Vichy Laboratoires, Levallois-Perret, France
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Longitudinal study of the scalp microbiome suggests coconut oil to enrich healthy scalp commensals. Sci Rep 2021; 11:7220. [PMID: 33790324 PMCID: PMC8012655 DOI: 10.1038/s41598-021-86454-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 02/04/2021] [Indexed: 01/03/2023] Open
Abstract
Dandruff is a recurrent chronic scalp disorder, affecting majority of the population worldwide. Recently a metagenomic study of the Indian scalp microbiome described an imperative role of bacterial commensals in providing essential vitamins and amino acids to the scalp. Coconut oil and its formulations are commonly applied on the scalp in several parts of the world to maintain scalp health. Thus, in this study we examined the effect of topical application of coconut oil on the scalp microbiome (bacterial and fungal) at the taxonomic and functional levels and their correlation with scalp physiological parameters. A 16-weeks-long time-course study was performed including 12-weeks of treatment and 4-weeks of relapse phase on a cohort of 140 (70 healthy and 70 dandruff) Indian women, resulting in ~ 900 metagenomic samples. After the treatment phase, an increase in the abundance of Cutibacterium acnes and Malassezia globosa in dandruff scalp was observed, which were negatively correlated to dandruff parameters. At the functional level, an enrichment of healthy scalp-related bacterial pathways, such as biotin metabolism and decrease in the fungal pathogenesis pathways was observed. The study provides novel insights on the effect of coconut oil in maintaining a healthy scalp and in modulating the scalp microbiome.
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De Pessemier B, Grine L, Debaere M, Maes A, Paetzold B, Callewaert C. Gut-Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin Conditions. Microorganisms 2021; 9:353. [PMID: 33670115 PMCID: PMC7916842 DOI: 10.3390/microorganisms9020353] [Citation(s) in RCA: 190] [Impact Index Per Article: 63.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/25/2021] [Accepted: 02/07/2021] [Indexed: 02/06/2023] Open
Abstract
The microbiome plays an important role in a wide variety of skin disorders. Not only is the skin microbiome altered, but also surprisingly many skin diseases are accompanied by an altered gut microbiome. The microbiome is a key regulator for the immune system, as it aims to maintain homeostasis by communicating with tissues and organs in a bidirectional manner. Hence, dysbiosis in the skin and/or gut microbiome is associated with an altered immune response, promoting the development of skin diseases, such as atopic dermatitis, psoriasis, acne vulgaris, dandruff, and even skin cancer. Here, we focus on the associations between the microbiome, diet, metabolites, and immune responses in skin pathologies. This review describes an exhaustive list of common skin conditions with associated dysbiosis in the skin microbiome as well as the current body of evidence on gut microbiome dysbiosis, dietary links, and their interplay with skin conditions. An enhanced understanding of the local skin and gut microbiome including the underlying mechanisms is necessary to shed light on the microbial involvement in human skin diseases and to develop new therapeutic approaches.
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Affiliation(s)
- Britta De Pessemier
- Center for Microbial Ecology and Technology, Ghent University, Coupure Links 653, 9000 Ghent, Belgium; (B.D.P.); (M.D.); (A.M.)
| | - Lynda Grine
- Department of Head & Skin, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium;
| | - Melanie Debaere
- Center for Microbial Ecology and Technology, Ghent University, Coupure Links 653, 9000 Ghent, Belgium; (B.D.P.); (M.D.); (A.M.)
| | - Aglaya Maes
- Center for Microbial Ecology and Technology, Ghent University, Coupure Links 653, 9000 Ghent, Belgium; (B.D.P.); (M.D.); (A.M.)
| | | | - Chris Callewaert
- Center for Microbial Ecology and Technology, Ghent University, Coupure Links 653, 9000 Ghent, Belgium; (B.D.P.); (M.D.); (A.M.)
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Castillo-González R, Cibrian D, Sánchez-Madrid F. Dissecting the complexity of γδ T-cell subsets in skin homeostasis, inflammation, and malignancy. J Allergy Clin Immunol 2020; 147:2030-2042. [PMID: 33259837 DOI: 10.1016/j.jaci.2020.11.023] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/12/2020] [Accepted: 11/17/2020] [Indexed: 12/14/2022]
Abstract
γδ T cells are much less common than αβ T cells, accounting for 0.5% to 5% of all T lymphocytes in the peripheral blood and lymphoid tissues in mice and humans. However, they are the most abundant T-lymphocyte subset in some epithelial barriers such as mouse skin. γδ T cells are considered innate lymphocytes because of their non-MHC restricted antigen recognition, as well as because of their rapid response to cytokines, invading pathogens, and malignant cells. Exacerbated expansion and activation of γδ T cells in the skin is a common feature of acute and chronic skin inflammation such as psoriasis and contact or atopic dermatitis. Different γδ T-cell subsets showing differential developmental and functional features are found in mouse and human skin. This review discusses the state of the art of research and future perspectives about the role of the different subsets of γδ T-cells detected in the skin in steady-state, psoriasis, dermatitis, infection, and malignant skin diseases. Also, we highlight the differences between human and mouse γδ T cells in skin homeostasis and inflammation, as understanding the differential role of each subtype of skin γδ T cells will improve the discovery of new therapies.
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Affiliation(s)
- Raquel Castillo-González
- Immunology Service, Hospital de la Princesa, Instituto Investigación Sanitaria Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Danay Cibrian
- Immunology Service, Hospital de la Princesa, Instituto Investigación Sanitaria Princesa, Universidad Autónoma de Madrid, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; CIBER de Enfermedades Cardiovasculares, Carlos III Health Institute, Madrid, Spain.
| | - Francisco Sánchez-Madrid
- Immunology Service, Hospital de la Princesa, Instituto Investigación Sanitaria Princesa, Universidad Autónoma de Madrid, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain; CIBER de Enfermedades Cardiovasculares, Carlos III Health Institute, Madrid, Spain.
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10
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Novel sulfamoylbenzoates as antifungal agents against Malassezia furfur. MENDELEEV COMMUNICATIONS 2020. [DOI: 10.1016/j.mencom.2020.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Bagatin E, Costa CS, Rocha MADD, Picosse FR, Kamamoto CSL, Pirmez R, Ianhez M, Miot HA. Consensus on the use of oral isotretinoin in dermatology - Brazilian Society of Dermatology. An Bras Dermatol 2020; 95 Suppl 1:19-38. [PMID: 33036809 PMCID: PMC7772596 DOI: 10.1016/j.abd.2020.09.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 05/11/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Isotretinoin is a synthetic retinoid, derived from vitamin A, with multiple mechanisms of action and highly effective in the treatment of acne, despite common adverse events, manageable and dose-dependent. Dose-independent teratogenicity is the most serious. Therefore, off-label prescriptions require strict criteria. OBJECTIVE To communicate the experience and recommendation of Brazilian dermatologists on oral use of the drug in dermatology. METHODS Eight experts from five universities were appointed by the Brazilian Society of Dermatology to develop a consensus on indications for this drug. Through the adapted DELPHI methodology, relevant elements were listed and an extensive analysis of the literature was carried out. The consensus was defined with the approval of at least 70% of the experts. RESULTS With 100% approval from the authors, there was no doubt about the efficacy of oral isotretinoin in the treatment of acne, including as an adjunct in the correction of scars. Common and manageable common adverse events are mucocutaneous in nature. Others, such as growth retardation, abnormal healing, depression, and inflammatory bowel disease have been thoroughly investigated, and there is no evidence of a causal association; they are rare, individual, and should not contraindicate the use of the drug. Regarding unapproved indications, it may represent an option in cases of refractory rosacea, severe seborrheic dermatitis, stabilization of field cancerization with advanced photoaging and, although incipient, frontal fibrosing alopecia. For keratinization disorders, acitretin performs better. In the opinion of the authors, indications for purely esthetic purposes or oil control are not recommended, particularly for women of childbearing age. CONCLUSIONS Approved and non-approved indications, efficacy and adverse effects of oral isotretinoin in dermatology were presented and critically evaluated.
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Affiliation(s)
- Ediléia Bagatin
- Department of Dermatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | | | - Fabíola Rosa Picosse
- Department of Dermatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | - Rodrigo Pirmez
- Centro de Estudos dos Cabelos, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Mayra Ianhez
- Department of Tropical Medicine and Dermatology, Universidade Federal de Goiás, Goiânia, GO, Brazil
| | - Hélio Amante Miot
- Department of Dermatology, Faculdade de Ciências Médicas e Biológicas de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil.
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Dyląg M, Leniak E, Gnat S, Szepietowski JC, Kozubowski L. A case of anti- pityriasis versicolor therapy that preserves healthy mycobiome. BMC DERMATOLOGY 2020; 20:9. [PMID: 32993612 PMCID: PMC7526128 DOI: 10.1186/s12895-020-00106-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 09/20/2020] [Indexed: 11/27/2022]
Abstract
Background The impact of Malassezia yeasts on skin mycobiome and health has received considerable attention recently. Pityriasis versicolor (PV), a common dermatosis caused by Malassezia genus worldwide, is a manifestation of dysbiosis. PV can be associated with hyper- and/or hypopigmented skin lesions. This disease entity is characterized by high percentage of relapses, which demands a proper antifungal therapy that is based on unambiguous species identification and drug susceptibility testing. Case presentation Comprehensive analysis of PV case in man presenting simultaneously hyper- and hypopigmented skin lesions was performed. Conventional and molecular diagnostic procedures revealed Malassezia furfur and Malassezia sympodialis, respectively as etiological agents of skin lesions observed. Susceptibility tests showed significantly lowered sensitivity of M. furfur cells to fluconazole. Based on susceptibility profiles local antifungal therapy with drugs characterized by entirely different mechanism of action was included. Conclusions Our study indicates that cases of PV represented by two types of skin lesions in one patient may be associated with distinct Malassezia species. Moreover, as observed in this case, each of the isolated etiological agents of PV may differ significantly in susceptibility to antifungals. This can significantly complicate the treatment of dermatosis, which by definition is associated with a significant percentage of relapses. In the presented case localized topical treatment was sufficient and successful while allowing maintaining the physiological mycobiome.
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Affiliation(s)
- Mariusz Dyląg
- Department of Mycology and Genetics, Institute of Genetics and Microbiology, University of Wroclaw, Wroclaw, Poland.
| | - Ewa Leniak
- Max Planck Institute of Molecular Plant Physiology, 14476, Potsdam, Germany
| | - Sebastian Gnat
- Department of Veterinary Microbiology, Institute of Biological Bases of Animal Diseases, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, Lublin, Poland
| | - Jacek C Szepietowski
- Department and Clinic of Dermatology, Venereology and Allergology Wroclaw Medical University, Wroclaw, Poland
| | - Lukasz Kozubowski
- Department of Genetics and Biochemistry, Clemson University, Clemson, SC, USA
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Torres M, de Cock H, Celis Ramírez AM. In Vitro or In Vivo Models, the Next Frontier for Unraveling Interactions between Malassezia spp. and Hosts. How Much Do We Know? J Fungi (Basel) 2020; 6:jof6030155. [PMID: 32872112 PMCID: PMC7558575 DOI: 10.3390/jof6030155] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/08/2020] [Accepted: 08/10/2020] [Indexed: 12/18/2022] Open
Abstract
Malassezia is a lipid-dependent genus of yeasts known for being an important part of the skin mycobiota. These yeasts have been associated with the development of skin disorders and cataloged as a causal agent of systemic infections under specific conditions, making them opportunistic pathogens. Little is known about the host-microbe interactions of Malassezia spp., and unraveling this implies the implementation of infection models. In this mini review, we present different models that have been implemented in fungal infections studies with greater attention to Malassezia spp. infections. These models range from in vitro (cell cultures and ex vivo tissue), to in vivo (murine models, rabbits, guinea pigs, insects, nematodes, and amoebas). We additionally highlight the alternative models that reduce the use of mammals as model organisms, which have been gaining importance in the study of fungal host-microbe interactions. This is due to the fact that these systems have been shown to have reliable results, which correlate with those obtained from mammalian models. Examples of alternative models are Caenorhabditis elegans, Drosophila melanogaster, Tenebrio molitor, and Galleria mellonella. These are invertebrates that have been implemented in the study of Malassezia spp. infections in order to identify differences in virulence between Malassezia species.
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Affiliation(s)
- Maritza Torres
- Grupo de Investigación Celular y Molecular de Microorganismos Patógenos (CeMoP), Departamento de Ciencias Biológicas, Universidad de los Andes, Carrera 1 N° 18A—12, Bogotá, Bogotá D.C. 11711, Colombia;
| | - Hans de Cock
- Microbiology, Department of Biology, Faculty of Science, Institute of Biomembranes, Utrecht University, Padualaan 8, 3584 CH Utrecht, The Netherlands;
| | - Adriana Marcela Celis Ramírez
- Grupo de Investigación Celular y Molecular de Microorganismos Patógenos (CeMoP), Departamento de Ciencias Biológicas, Universidad de los Andes, Carrera 1 N° 18A—12, Bogotá, Bogotá D.C. 11711, Colombia;
- Correspondence:
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14
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Zurro NB, de Oliveira Junior EB, França TT, Dantas VM, Tavares de Albuquerque JA, Condino-Neto A. Unusual Severe Seborrheic Dermatitis in Two Siblings with Autosomal Recessive Chronic Granulomatous Disease. J Clin Immunol 2019; 39:836-838. [DOI: 10.1007/s10875-019-00681-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 08/09/2019] [Indexed: 10/26/2022]
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15
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Zander N, Sommer R, Schäfer I, Reinert R, Kirsten N, Zyriax B, Maul J, Augustin M. Epidemiology and dermatological comorbidity of seborrhoeic dermatitis: population‐based study in 161 269 employees. Br J Dermatol 2019; 181:743-748. [DOI: 10.1111/bjd.17826] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2019] [Indexed: 01/05/2023]
Affiliation(s)
- N. Zander
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - R. Sommer
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - I. Schäfer
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - R. Reinert
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - N. Kirsten
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - B.‐C. Zyriax
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - J.‐T. Maul
- Department of Dermatology University Hospital of Zurich Zurich Switzerland
| | - M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
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16
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Assessing Biophysical and Physiological Profiles of Scalp Seborrheic Dermatitis in the Thai Population. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5128376. [PMID: 31360714 PMCID: PMC6644260 DOI: 10.1155/2019/5128376] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/02/2019] [Indexed: 12/19/2022]
Abstract
Background Scalp seborrheic dermatitis (SD) is a common and chronic inflammatory skin disease which tends to recur over time. By measuring biophysical properties of the stratum corneum, many studies report abnormal biophysical profiles and their association in various dermatologic diseases. The aim of the study is to analyze the biophysical properties and skin barrier defects of scalp SD compared to healthy controls. Materials and Methods This study is a cross-sectional study assessing the correlation of various biophysical and physiological profiles in scalp SD. Forty-two Thai participants with scalp SD were enrolled in the study and 40 healthy participants were also enrolled as the control group. Both SD and control group were subjected to a one-time biophysical and physiological properties' measurement of transepidermal water loss (TEWL), stratum corneum hydration (SCH), skin surface pH, skin surface lipid, and skin roughness. Results The mean TEWL of lesional skin of SD cases were significantly higher than those of control group (P<0.05). Relating to high mean TEWL, the mean SCH was found to be significantly lower in SD cases (P<0.05). Skin surface lipid was also found to be significantly higher in SD group (P<0.05). However, there were no differences in skin surface pH (P=0.104) and roughness (P=0.308) between the two groups. Pairwise comparison of each subgroup found that moderate and severe SD demonstrated significantly higher mean skin surface lipid than that of control group (P<0.05). Conclusion Scalp SD may be associated with seborrhea in Thai population. Monitoring of SCH, TEWL, and skin surface lipid could be helpful in assessing severity and evaluating the treatment outcome in patients with scalp SD.
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Putting It All Together to Understand the Role of Malassezia spp. in Dandruff Etiology. Mycopathologia 2018; 183:893-903. [PMID: 29946996 DOI: 10.1007/s11046-018-0283-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 06/21/2018] [Indexed: 01/01/2023]
Abstract
Dandruff is a common scalp condition causing both a discomfort and an undesired social image. Various studies dating from early 1900s have investigated the condition, but understanding of underlying mechanisms and etiology of the condition is still in its infancy. Formation of dandruff is a common but complex event which has been associated with numerous causal factors. Physiological conditions such as pH, water content, or sebum secretion are some of the host-related factors. An imbalance between these factors can disturb the physiological equilibrium of the scalp that can lead to dandruff formation. However, severity of the condition is strongly related to the lipophilic yeast of the skin microbiota, Malassezia spp. On the other hand, there are recent publications highlighting the role of other scalp microbiota members on dandruff formation. This review investigates the processes leading to the formation of dandruff to provide an etiological description of the condition, with a focus on Malassezia spp.
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