Noncorticosteroid Combination Shampoo versus 1% Ketoconazole Shampoo for the Management of Mild-to-Moderate Seborrheic Dermatitis of the Scalp: Results from a Randomized, Investigator-Single-Blind Trial Using Clinical and Trichoscopic Evaluation

Topical moisturizer with rose stem cell-derived exosomes (RSCEs) for recalcitrant seborrheic dermatitis: A case report with 6 months of follow-up

INTRODUCTION

Seborrheic dermatitis (SD) poses significant treatment challenges due to its chronic nature and the side effects associated with long-term use of conventional therapies like topical corticosteroids. In the search for alternative treatments, exosomes, particularly those derived from rose stem cells (RSCEs), offer a promising avenue due to their potential in managing chronic skin conditions.

OBJECTIVE

This case report examines the efficacy of a topical moisturizer containing RSCEs in treating a patient with refractory SD, aiming to provide an alternative treatment pathway.

MATERIALS AND METHODS

A 40-year-old male with a long-standing history of SD, unresponsive to traditional treatments, underwent a novel treatment regimen. This regimen included an initial topical application of 2.5 mL of RSCEs followed by a maintenance phase involving the application of a RSCE-containing moisturizer. Clinical outcomes were assessed through the Patient's Global Assessment (PGA) and Investigator's Global Assessment (IGA) scores, along with evaluations of scaling and erythema.

RESULTS

Remarkable clinical improvement was noted as early as 1-day post-treatment, with significant reductions in redness, scaling, and itching. The patient experienced sustained relief throughout the 6-month follow-up, with a recurrence in the sixth month that was less severe than previous flare-ups. This demonstrated not only the efficacy of RSCEs in symptom management but also their potential in extending remission periods.

CONCLUSION

The chronic management of SD can benefit from innovative treatments like the RSCE-containing moisturizer, as shown in this case report. While the observed outcomes are promising, indicating substantial improvements in skin condition and symptom management, larger controlled studies are necessary to validate the therapeutic potential of exosome-containing moisturizers fully. This case underscores the need for alternative therapies in SD treatment, highlighting the role of exosomes as a viable option.

Treatment of cradle cap in infants with a new cosmetic non-steroidal gel cream: Clinical, laboratory, and instrumental evaluation

Background

Cradle cap is a benign and self‐limiting variant of seborrheic dermatitis (SD) that can be distressing for parents.

Aims

To assess by clinical/laboratory/instrumental evaluation the efficacy/tolerability of a gel cream containing piroctone olamine (antifungal), biosaccharide gum‐2 (antifungal), stearyl glycyrrhetinate (anti‐inflammatory), and zinc l‐pyrrolidone carboxylate (zinc‐PCA) (antiseborrheic) in the treatment of mild/ moderate cradle cap.

Methods

In this prospective, open‐label trial, 10 infants, with mild/moderate cradle cap enrolled at the Dermatology University Clinic of Catania (Italy) used the tested gel cream twice daily for 30 days. Degree of erythema was evaluated clinically by a 5‐point severity scale (from 0=no erythema to 4=severe erythema), at baseline, at 15 and 30 days. Desquamation was rated by dermoscopy evaluation using a 5‐point scale (from 0=no desquamation to 4=severe/many large adherent white flakes), at all time points. An Investigator Global Assessment (IGA) using a 6‐point scale (from −1=worsening to 4=complete response/clear) was also performed at 30 days. Five subjects, randomly selected, underwent double microbiological evaluation for bacteria and yeasts by cultures of cotton swabs at baseline and at 30 days. Tolerability/acceptability was evaluated on a 4‐point scale (from 0=very poor to 3=excellent) at 15 and 30 days. Data were processed using SAS version 9.

Results

At baseline, a significant colony‐forming unit (CFU) count for Malassezia furfur and Staphylococcus aureus was detected in 4 out of 5 selected patients. After 15 and 30 days, a statically significant reduction from baseline in erythema and desquamation severity was observed, along with a reduction in CFU count for Malassezia furfur and Staphylococcus aureus from baseline. No signs of local side effects were documented.

Conclusions

Our results indicate that the tested gel cream may represent a valid option to treat mild‐to‐moderate forms of cradle cap and support its antifungal and antibacterial properties.

Shikimic acid in the light of current knowledge

Shikimic acid (SA) has been mainly used in the pharmaceutical industry for production of drugs, however, recently it has also appeared in the world of cosmetics. So far, there have not been many publications on cosmetics containing SA or research studies on the compound, especially those that would involve testing cosmetic products on subjects. The main source of SA is star anise. The recommended concentration of SA in cosmetic preparations ranges between 1 and 5%. The pH of a 5% solution of SA in water is 3. SA at a concentration of 5% has a similar exfoliative effect to that of 50% glycolic acid. It shows antiviral, exfoliating, deodorizing, anti-acne, anti-dandruff, whitening and moisturizing activity. It also regulates the amount of secreted sebum, moreover, it has antibacterial, anti-inflammatory, hair-growth stimulating, anti-aging effect and antifungal properties.

Novel Non-Steroidal Facial Cream Demonstrates Antifungal and Anti-Inflammatory Properties in Ex Vivo Model for Seborrheic Dermatitis

INTRODUCTION

Seborrheic dermatitis (SEBD) is a chronic, recurrent skin disorder that typically occurs as an inflammatory response to fungi of the genus Malassezia. The development of an ex vivo model that mimics the fungal proliferation and skin inflammation of SEBD would play an important role in screening formulations for their efficacy in treating SEBD.

METHODS

An ex vivo model for SEBD using human skin explants that had been mechanically manipulated to facilitate colonization of Malassezia furfur was developed. This model was used to evaluate the efficacy of a novel non-steroidal facial cream (NSFC) in inhibiting M. furfur proliferation and reducing inflammatory cytokine levels.

RESULTS

This model reproduced some of the key pathological features of SEBD, including M. furfur proliferation and inflammatory cytokine production. Topical application of NSFC facial cream reduced M. furfur counts by 92% (p < 0.05) and levels of interleukin 8 (IL-8) and tumor necrosis factor alpha (TNF-α) by 82% and 40%, respectively (p < 0.05, both).

CONCLUSION

The proposed ex vivo model for SEBD could be a useful tool to evaluate topical antifungal treatments. The novel NSFC tested in this study reduced M. furfur proliferation and inflammatory cytokine levels following topical application and may be helpful in the management of SEBD.

FUNDING

ISDIN.

Scalp Seborrheic Dermatitis and Dandruff Therapy Using a Herbal and Zinc Pyrithione-based Therapy of Shampoo and Scalp Lotion

Objective: The aim of this study was to evaluate the safety and efficacy of an herbal and zinc pyrithione shampoo and a scalp lotion (Kamedis Derma-Scalp Dandruff Therapy, Kamedis Ltd., Tel Aviv, Israel) for the treatment of scalp seborrheic dermatitis and dandruff. Design: This was an interventional, open-label, safety and efficacy study. Setting: This open-label study was conducted at Consumer Product Testing Company Inc. in Fairfield, New Jersey. At the baseline visit (Day 0), an examination of the scalp was conducted by a board-certified dermatologist. The entire scalp was evaluated for evidence of seborrheic dermatitis using the Adherent Scalp Flaking Score with a 10-point scale. Only subjects with evidence of moderate-to-greater seborrheic dermatitis or moderate-to-greater dandruff were deemed qualified for inclusion in the study. Participants: Fifty subjects were recruited and included in the study. Measurements: Study subjects were evaluated by the same dermatologist for erythema and flaking at Days 0, 14, 28, and 42 using a five-point scale for each parameter. At each time point, a total severity score was calculated based on the findings of the evaluations. Following the scalp evaluation, each subject had a standardized digital photograph taken of his or her scalp. Each subject was also asked to answer a satisfaction questionnaire regarding the product treatment enhancement and characteristics. Results: A reduction in both parameters evaluated was seen at all time points. Statistical significance was achieved at each time point when compared with the baseline visit. In addition, the subjects expressed a high degree of satisfaction with the treatment. No adverse events were reported during this study. Conclusion: The study showed that the herbal zinc pyrithione shampoo and scalp lotion provided improvement in the main symptoms of seborrheic dermatitis.

Treatment of Seborrhoeic Dermatitis in Asia: A Consensus Guide

Seborrhoeic dermatitis (SD) is common in Asia. Its prevalence is estimated to be 1-5% in adults. However, larger population-based studies into the epidemiology of SD in Asia are lacking, and the aetiology of SD may differ widely from Western countries and in different parts of Asia. In addition, clinically significant differences between Asian and Caucasian skin have been reported. There is a need to define standardized clinical diagnostic criteria and/or a grading system to help determine appropriate treatments for SD within Asia. With this in mind, experts from India, South Korea, Taiwan, Malaysia, Vietnam, Singapore, Thailand, the Philippines, Indonesia, and Italy convened to define the landscape of SD in Asia at a meeting held in Singapore. The consensus group developed a comprehensive algorithm to aid clinicians to recommend appropriate treatment of SD in both adults and children. In most cases, satisfactory therapeutic results can be accomplished with topical antifungal agents or topical corticosteroids. Non-steroidal anti-inflammatory agents with antifungal properties have been shown to be a viable option for both acute and maintenance therapy.