Introduction: Seborrheic dermatitis is a chronic and recurrent inflammatory dermatosis affecting different age groups with a prevalence rate of 1–5% among Asian adults. Due to its immune-modulatory and anti-inflammatory properties, vitamin D has been correlated with inflammatory dermatoses such as seborrheic dermatitis. Objectives: To determine the prevalence of vitamin D insufficiency, deficiency and severe deficiency among Filipino adult pa- tients with moderate to severe seborrheic dermatitis. Methods: A single-center, analytical, cross-sectional study at Makati Medical Center, which included Filipino patients aged 18– 60 years, diagnosed with moderate-to-severe seborrheic dermatitis based on Investigator's Static Global Assessment (ISGA) with serum vitamin D levels classified as normal, insufficient, deficient and severely deficient. Results: We included 61 patients, 5 patients (8%) of whom presented with normal Vitamin D levels. Twenty-one patients (34%) pre- sented with vitamin D insufficiency, 32 patients (52%) presented with vitamin D deficiency, while 3 patients (5%) presented with se- vere deficiency. Vitamin D insufficiency and deficiency were more prevalent among patients in the younger age group (p = 0.001), with predominant scalp lesions (p = 0.006), and those who are single (p = 0.015). There was no statistically significant difference in the prevalence of vitamin D insufficiency and/or deficiency based on seborrheic dermatitis severity as per ISGA scale (p = 0.126). Conclusion Seborrheic dermatitis in Filipinos has been associated with vitamin D insufficiency, deficiency and severe defi- ciency. The prevalence of vitamin D deficiency is seen in almost half of patients while vitamin D insufficiency is seen in almost one-third of patients with seborrheic dermatitis. While topical and oral medications have been the treatment of choice for seb- orrheic dermatitis, the role of oral vitamin D supplementation as adjunct treatment may be studied.
Dermatitis, Seborrheic ; Vitamin D Deficiency

BACKGROUND: In Korea, new human immunodeficiency virus (HIV) patients continue to be diagnosed. Due to the development of highly active anti-retroviral therapy (HAART) and lengthening of survival period of infected person, the aspect of skin diseases of HIV-infected patients is also changing. OBJECTIVE: To determine skin diseases of HIV-infected patients according to immune status and the relationship between folliculitis and HAART drug. METHODS: Subjects were HIV-infected patients who were treated in the department of dermatology from September 1, 2008 to August 31, 2018. Medical records of 376 subjects were retrospectively analyzed. RESULTS: Of 376 patients were studied, tinea infection, folliculitis, and seborrheic dermatitis were the most common regardless of their CD4 T cell counts or treatment group (initial treatment or retreatment). Seborrheic dermatitis, irritant contact dermatitis, and pruritic papular eruption were significantly more common in patients with CD4+T cells less than 200×106 cells/L while warts were significantly more frequent in patients with CD4+T cells greater than 200×106 cells/L. Most HAART agents were found to be helpful in reducing the incidence of folliculitis. CONCLUSION: There were many skin diseases in HIV patients, different from previous studies. In our study, the top three diagnoses were tinea infection, folliculitis, and seborrheic dermatitis. HAART medication was helpful in reducing folliculitis. These changes will require different treatments for skin diseases in HIV patients.
Acquired Immunodeficiency Syndrome ; Antiretroviral Therapy, Highly Active ; Cell Count ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Dermatology ; Diagnosis ; Folliculitis ; HIV ; Humans ; Incidence ; Korea ; Medical Records ; Retrospective Studies ; Skin Diseases ; Skin ; Tinea ; Warts

BACKGROUND: To date, numerous studies have investigated the epidemiology and clinical characteristics of male pattern hair loss (MPHL). OBJECTIVE: The purpose of this study was to evaluate a large number of long-term MPHL patients and to compare them to shorter term ones from other studies. METHODS: We retrospectively reviewed charts of patients diagnosed with MPHL during a 10-year period at the alopecia clinic at the Department of Dermatology of Myongji Hospital. RESULTS: Among 3,549 alopecia patients who had visited the hospital's alopecia clinic, 1,360 were patients demonstrating MPHL (38.3%). The most frequent age group was patients in their 20's (30.1%) followed by those in their 30's (28.2%), 40's (17.2%), 50's (9.9%), and teenagers (8.9%). There were 599 MPHL patients (44.0%) with a paternal familial predisposition, 182 (13.4%) with a maternal familial predisposition, and 118 (8.7%) with familial predisposition on maternal and paternal sides. MPHL was classified based on the Norwood-Hamilton classification: type 2 (20.0%), type 3v (19.4%), and type 3a (16.3%) were the most frequent. Abnormalities in total serum cholesterol were found in 15.1% patients and triglycerides in 36.1% of patients. The most common comorbidity was seborrheic dermatitis, followed by hypertension, hyperlipidemia, diabetes mellitus, and gastrointestinal diseases. CONCLUSION: This study demonstrated that the period of MPHL diagnosis and treatment becomes earlier in age and milder regarding MPHL type, which may be due to early puberty in teenagers.
Adolescent ; Alopecia ; Cholesterol ; Classification ; Comorbidity ; Dermatitis, Seborrheic ; Dermatology ; Diabetes Mellitus ; Diagnosis ; Epidemiology ; Gastrointestinal Diseases ; Hair* ; Humans ; Hyperlipidemias ; Hypertension ; Male* ; Puberty ; Retrospective Studies ; Triglycerides

BACKGROUND: A new shampoo with anti-Malassezia properties obtained from various plants is required to provide seborrheic dermatitis patients with a wider range of treatment options. OBJECTIVE: The aim of this study was to obtain in vitro susceptibility profiles of Malassezia restricta and M. globosa, the most important pathogenic organisms in the development of seborrheic dermatitis, to the plant extracts used in commercial anti-dandruff shampoos. METHODS: Minimal inhibitory concentrations (MICs) were determined for eight candidate plant extracts and two plant-derived natural products diluted with Leeming and Notman medium to final concentrations of 0.016 to 1 mg/ml. RESULTS: Castanea crenata shell, Camellia sinensis leaf, and oil-soluble Glycyrrhiza extracts presented relatively low MIC values (≤0.5 mg/ml) against both strains. The C. crenata shell and oil-soluble Glycyrrhiza extracts demonstrated especially high anti-Malassezia activity, suggesting their potential use in the treatment of seborrheic dermatitis. The extracts also showed fungistatic activity against other common facultative pathogenic yeasts, Cryptococcus and Candida. CONCLUSION: C. crenata shell and oil-soluble Glycyrrhiza extracts could potentially be used as active ingredients in anti-seborrheic and anti-dandruff shampoo formulations. They could be helpful for repeated treatments and regular prophylaxis of scalp seborrheic dermatitis.
Biological Products ; Camellia sinensis ; Candida ; Cryptococcus ; Dermatitis, Seborrheic ; Glycyrrhiza* ; Humans ; In Vitro Techniques* ; Malassezia ; Plant Extracts ; Scalp ; Yeasts

BACKGROUND: Malasseiza species are dimorphic and lipophilic fungi which are part of normal mycota of the human skin, and also associated with some skin diseases. In many skin diseases such as pityriasis versicolor, Malassezia folliculitis, seborrheic dermatitis, atopic dermatitis and psoriasis, Malassezia yeasts may have a key role. OBJECTIVE: To investigate susceptibility of antifungal agent including itraconazole, fluconazole and terbinafine, we conducted in vitro susceptibility test revealing minimum inhibitory concentration of drugs for each Malassezia strains. METHODS: Malassezia restricta CBS7877, M. globosa CBS 7966, M. slooffiae KCTC 27517, M. sympodialis CBS 7222, M. pachydermatis CBS 1879 and M. furfur CBS 1878 were used in this experiment. The strains were grown in Leeming and Notman medium. MIC was determined using the method suggested by Sugita, et al. with modification. Malassezia cells were grown in each well and incubated for 2 days at 34℃, and MIC was determined by agar dilution method. RESULTS: Most Malasseiza strains of all Malassezia species were most sensitive to itraconazole, with MICs ranging from 0.015 to 0.06 µg/mL. MIC values of fluconazole and terbinafine against Malassezia species were higher and wider range than MIC of itraconazole. CONCLUSION: Itracozanole would be the first choice drug for treatment of Malassezia associated skin diseases. Isolation of pathologic species of Malassezia from various skin diseases in Korea would be fundamental research for the target therapy, and drug susceptibility test would be helpful for proper treatment.
Agar ; Dermatitis, Atopic ; Dermatitis, Seborrheic ; Fluconazole* ; Folliculitis ; Fungi ; Humans ; In Vitro Techniques* ; Itraconazole* ; Korea ; Malassezia* ; Methods ; Microbial Sensitivity Tests ; Psoriasis ; Skin ; Skin Diseases ; Tinea Versicolor ; Yeasts

Seborrheic dermatitis is a chronic, recurrent papulosquamous skin disorder characterized by flaking of the skin, erythema, pruritus, and oily skin. It is a common dermatosis, with a prevalence of approximately 1% to 3% of the general population in the United States. The incidence of this skin disease has a bimodal distribution, with peaks noted in newborns and in adults between 30 and 60 years of age. In adults, it predominantly occurs over areas of the body with a high concentration of sebaceous glands. The etiology of this disease is thought to be an inflammatory response of the body to Malassezia yeasts. It is also related to abnormal sebum secretion, as well as a heightened immune response of the host. Based on the characteristic features of this inflammatory skin disease, the mainstays of treatment for seborrheic dermatitis are antifungals, corticosteroids, and immunomodulatory agents. The primary goal of therapy for seborrheic dermatitis is to manage acute symptoms, including pruritus, erythema, and scaling. Maintenance treatment is directed toward preventing the recurrence of acute exacerbations. Patients should be informed that seborrheic dermatitis is a chronic condition, with a tendency to recur despite proper treatment. Clinicians should offer suggestions about lifestyle modifications to avoid triggers and choose proper treatment options that ensure the patient's safety.
Adrenal Cortex Hormones ; Adult ; Dandruff ; Dermatitis, Seborrheic* ; Erythema ; Humans ; Incidence ; Infant, Newborn ; Life Style ; Malassezia ; Prevalence ; Pruritus ; Recurrence ; Sebaceous Glands ; Sebum ; Skin ; Skin Diseases ; United States ; Yeasts

BACKGROUND: Cosmetics can affect the skin condition profoundly, and yet no survey has been performed in Koreans visiting dermatology clinics. OBJECTIVE: To assess knowledge and consumer behavior regarding cosmetics in Koreans visiting dermatology clinics. METHODS: A questionnaire consisting of 43 questions concerning demographics and use/knowledge/selection/purchase of cosmetics was given to patients and accompanying persons who visited dermatologic clinics in university and private clinic settings. RESULTS: In total 1,015 subjects (73.2% females, mean age 32.5 years) completed the survey. Education level was college or higher in 72.8%. Thirty-one percent had been diagnosed with a skin disorder, atopic dermatitis and seborrheic dermatitis being the most frequent diagnoses (33.7% and 16.8%, respectively). The frequency of makeup/sunscreen/functional cosmetics use, amount of sunscreen use, recognition of functional cosmetics, and knowledge of shelf life were significantly correlated with level of education. Among “functional cosmetics,” whitening products were used most frequently (29.2%). Regardless of education level, 79.2% purchased cosmetics without checking ingredients, and 85.7% were unaware of the all-ingredient-labelling regulations, and yet subjects considered ingredient the most important factor when purchasing a product. CONCLUSION: Outpatient subjects in their twenties and thirties are the most knowledgeable about cosmetics in Korea.
Consumer Behavior ; Demography ; Dermatitis, Atopic ; Dermatitis, Seborrheic ; Dermatology* ; Diagnosis ; Education ; Female ; Humans ; Korea ; Outpatients ; Skin ; Skin Care ; Social Control, Formal

Zinc pyrithione (ZP) is commonly used to prevent dandruff and seborrheic dermatitis. Many consumers are exposed daily to high doses of ZP, causing serious concerns about its toxicity. The reproductive and developmental toxicities were previously reported in pregnant rats. However, the estrogenic activity of ZP at varying degrees of exposure has been rarely studied. Thus, we performed an uterotrophic assay, E-screen assay, and gene expression profiling to assess the estrogenic activity of ZP. For the uterotrophic assay, ZP (2, 10, or 50 mg/kg/d) was subcutaneously administered to ovariectomized rats every day for three days. Uteri were extracted 24 hours after the last dose. Then, wet and blotted uterine weights were measured. For the E-screen essay, MCF-7 cells (a breast cancer cell line) were exposed to 10⁻⁹ to 10⁻⁶ M of ZP, and cell proliferation was then measured. For the gene expression analysis, changes of gene expression levels in uterine samples taken for the uterotrophic assay were analyzed. In the uterotrophic assay, the concentration of ZP had no significant effect on uterine weight. In the E-screen assay, ZP at any concentration showed no significant increase in MCF-7 cell proliferation, compared to the control group. However, 10⁻⁶ M of ZP significantly reduced cell viability. The changes in gene expression slightly differed between the ZP and control groups. The in vivo and in vitro assays, together with gene expression analysis, demonstrated that ZP showed no significant estrogenic activity.
Animals ; Breast Neoplasms ; Cell Proliferation ; Cell Survival ; Dandruff ; Dermatitis, Seborrheic ; Estrogens* ; Gene Expression ; Gene Expression Profiling ; In Vitro Techniques* ; MCF-7 Cells ; Rats ; Uterus ; Weights and Measures ; Zinc*

Zinc pyrithione (ZP) is commonly used to prevent dandruff and seborrheic dermatitis. Many consumers are exposed daily to high doses of ZP, causing serious concerns about its toxicity. The reproductive and developmental toxicities were previously reported in pregnant rats. However, the estrogenic activity of ZP at varying degrees of exposure has been rarely studied. Thus, we performed an uterotrophic assay, E-screen assay, and gene expression profiling to assess the estrogenic activity of ZP. For the uterotrophic assay, ZP (2, 10, or 50 mg/kg/d) was subcutaneously administered to ovariectomized rats every day for three days. Uteri were extracted 24 hours after the last dose. Then, wet and blotted uterine weights were measured. For the E-screen essay, MCF-7 cells (a breast cancer cell line) were exposed to 10⁻⁹ to 10⁻⁶ M of ZP, and cell proliferation was then measured. For the gene expression analysis, changes of gene expression levels in uterine samples taken for the uterotrophic assay were analyzed. In the uterotrophic assay, the concentration of ZP had no significant effect on uterine weight. In the E-screen assay, ZP at any concentration showed no significant increase in MCF-7 cell proliferation, compared to the control group. However, 10⁻⁶ M of ZP significantly reduced cell viability. The changes in gene expression slightly differed between the ZP and control groups. The in vivo and in vitro assays, together with gene expression analysis, demonstrated that ZP showed no significant estrogenic activity.
Animals ; Breast Neoplasms ; Cell Proliferation ; Cell Survival ; Dandruff ; Dermatitis, Seborrheic ; Estrogens ; Gene Expression ; Gene Expression Profiling ; In Vitro Techniques ; MCF-7 Cells ; Rats ; Uterus ; Weights and Measures ; Zinc

Background: Seborrheic dermatitis is a chronic, relapsing, inflammatory disease characterized by erythema, scaling, pruritus over the areas of the scalp, face, ears, sternum and upper back. Tea tree oil is rich in terpene alcohols such as terpinen-4-ol which is thought to be the active germicidal component. Objective: To determine the efficacy of 5% tea tree oil cleanser in the treatment of mild-moderate facial seborrheic dermatitis and to determine the adverse side effects. Methods: Forty-five patients with clinical signs of seborrheic dermatitis were randomly assigned to one of the two treatment groups: mild cleanser and the 5% tea tree oil group. This study was done as a double-blind randomized controlled trial for 4 weeks. The parameters - area involved, erythema, scaling, and Seborrehea Area and Severity Index were taken at baseline and weekly for 4 weeks. At the end of 4 weeks, the difference of the two groups were compared using paired t-test. Results: After 4 weeks, significant clinical improvement of the area involved, erythema, and scaling and the reduction of Seborrhea Area and Severity Conclusion The use of 5% tea tree oil cleanser provides significant improvement in the treatment of mild-moderate facial seborrheic dermatitis with no adverse side effects.
Dermatitis, Seborrheic ; Tea Tree Oil