Łojotokowe zapalenie skóry
Epidemiologia
Łojotokowe zapalenie skóry (ŁZS) jest jedną z najczęstszych przewlekłych chorób zapalnych skóry, o globalnej częstości występowania około 4,38% (95% CI, 3,58-5,17%), z wyraźną heterogennością między populacjami. Choroba charakteryzuje się dwumodalnym lub trójmodalnym rozkładem zapadalności, z szczytami u niemowląt (2. tydzień do 12. miesiąca życia), młodych dorosłych oraz osób po 40. roku życia. Częstość występowania u dorosłych wynosi 5,64% (95% CI, 4,01-7,27%), u dzieci 3,70% (95% CI, 2,69-4,80%), a u noworodków 0,23% (95% CI, 0,04-0,43%). ŁZS występuje częściej u mężczyzn (6,6% vs. 5,4% u kobiet), co sugeruje rolę androgenów, choć u kobiet objawy mogą być bardziej nasilone. Choroba jest powszechna na całym świecie, z najwyższą częstością w RPA (8,82%) i najniższą w Indiach (2,62%). Szczególnie wysoka częstość występuje u pacjentów z HIV (35% w wczesnym zakażeniu, do 85% w AIDS) oraz u osób z chorobami neurologicznymi, zwłaszcza parkinsonizmem. Czynniki ryzyka obejmują warunki klimatyczne (zimny, suchy klimat), zanieczyszczenie powietrza (PM10 >120 μg/m³), stres, nadużywanie alkoholu (7-11%) oraz palenie tytoniu.
Epidemiologia łojotokowego zapalenia skóry
Łojotokowe zapalenie skóry (ŁZS) jest jedną z najczęstszych przewlekłych chorób zapalnych skóry na świecie. Szacowana globalna częstość występowania wynosi około 4,38% (95% CI, 3,58-5,17%), z istotną heterogennością między badaniami (I² = 99,94%)12. W samych Stanach Zjednoczonych na leczenie łupieżu, który jest najłagodniejszą postacią ŁZS, wydaje się rocznie około 300 milionów dolarów na preparaty dostępne bez recepty3.
Rozkład wiekowy
Łojotokowe zapalenie skóry charakteryzuje się dwumodalnym lub trójmodalnym rozkładem zapadalności w różnych grupach wiekowych:45
- Pierwszy szczyt występuje u niemowląt pomiędzy 2. tygodniem a 12. miesiącem życia, ze szczególnym nasileniem między 2. tygodniem a 3. miesiącem życia67
- Drugi szczyt pojawia się w okresie dojrzewania i wczesnej dorosłości58
- Trzeci szczyt obserwuje się po 40. roku życia, z najwyższą częstością występowania między 33. a 44. rokiem życia74
Analiza danych z badania Rotterdam Study wykazała, że 14% osób w średnim i starszym wieku cierpi na łojotokowe zapalenie skóry49. Według niektórych doniesień, u osób starszych częstość występowania może sięgać nawet 31%1011.
Meta-analizy wskazują na znaczące różnice w częstości występowania ŁZS w zależności od wieku:1
- Dorośli: 5,64% (95% CI, 4,01-7,27%)
- Dzieci: 3,70% (95% CI, 2,69-4,80%)
- Noworodki: 0,23% (95% CI, 0,04-0,43%)
Rozkład według płci
Łojotokowe zapalenie skóry występuje częściej u mężczyzn niż u kobiet we wszystkich grupach wiekowych, co sugeruje związek z hormonami płciowymi, takimi jak androgeny312. Według niektórych badań, częstość występowania u mężczyzn wynosi 6,6%, a u kobiet 5,4%13. Inne źródła podają stosunek 3,0% vs. 2,6% na korzyść mężczyzn12.
Warto zauważyć, że choć schorzenie częściej dotyka mężczyzn, u kobiet może przebiegać z większym nasileniem objawów1014. Szczyt zachorowań pojawia się u mężczyzn około 30. roku życia, a u kobiet około 40. roku życia8.
Rozkład geograficzny
Łojotokowe zapalenie skóry występuje na całym świecie, dotykając osoby wszystkich ras i grup etnicznych93. Jednak badania wskazują na znaczące różnice w częstości występowania w zależności od regionu geograficznego:15
- Najwyższa częstość występowania: Republika Południowej Afryki – 8,82% (95% CI, 3,00-14,64%)
- Najniższa częstość występowania: Indie – 2,62% (95% CI, 1,33-3,92%)
Badania przeprowadzone w Azji wykazały zróżnicowaną częstość występowania ŁZS w różnych krajach:16
- Indonezja: 26,45%
- Malezja: 17,16%
- Guangzhou (Chiny): 2,85%
- Makau: 2,66%
Częstość występowania w szczególnych populacjach
Częstość występowania łojotokowego zapalenia skóry jest znacząco wyższa w określonych grupach populacyjnych:
Pacjenci z zaburzeniami odporności
Szczególnie wysoką częstość występowania ŁZS obserwuje się u osób z zakażeniem HIV:54
- U pacjentów z wczesnym zakażeniem HIV: około 35%
- U pacjentów z AIDS: do 85%
Badanie obserwacyjne przeprowadzone na 401 pacjentach z ŁZS wykazało, że 198 (49,4%) było zakażonych HIV, a progresja lub zaostrzenie objawów ŁZS w stadium chorób wtórnych wystąpiło u 140 (76,5%) pacjentów z tej grupy17. Ciężkie i oporne na leczenie ŁZS może być związane z zakażeniem HIV i jest częste u niemowląt, u których rozwija się immunosupresja związana z HIV w pierwszym roku życia18.
Zaburzenia neurologiczne
Pacjenci z chorobami neurologicznymi, szczególnie z parkinsonizmem, często cierpią na łojotokowe zapalenie skóry519. W tych przypadkach ŁZS może być związane ze zwiększoną aktywnością gruczołów łojowych i może ulegać poprawie po zastosowaniu terapii L-DOPĄ5.
Inne schorzenia neurologiczne zwiększające ryzyko ŁZS to:20
- Udar mózgu
- Urazy głowy
- Porażenie nerwów czaszkowych
- Poważne paraliże tułowia
Różnice etniczne
Łojotokowe zapalenie skóry jest bardzo powszechne wśród pacjentów o ciemniejszym typie skóry21. Badania wykazały, że jest jednym z pięciu najczęstszych rozpoznań obserwowanych u pacjentów rasy czarnej2122.
Częstość występowania łupieżu, który jest łagodniejszą formą ŁZS, różni się również między grupami etnicznymi. Badanie przeprowadzone w USA i Chinach wykazało następującą częstość występowania łupieżu:23
- Afroamerykanie: 81-95%
- Osoby rasy kaukaskiej: 66-82%
- Osoby narodowości chińskiej: 30-42%
Czynniki ryzyka
Zidentyfikowano szereg czynników ryzyka dla rozwoju łojotokowego zapalenia skóry:
Czynniki środowiskowe
Warunki klimatyczne mogą wpływać na nasilenie ŁZS:2410
- Zimny i suchy klimat zwykle pogarsza przebieg choroby
- Sezonowy wzorzec: zwiększona częstość występowania w miesiącach zimowych6
- Gorąca pogoda może również nasilać objawy, gdyż sucha skóra może pogorszyć stan choroby10
Podwyższone poziomy zanieczyszczenia powietrza, szczególnie PM10, mogą negatywnie wpływać na jakość życia pacjentów z ŁZS. Badanie przeprowadzone w Chinach wykazało, że gdy jakość powietrza pogarsza się (poziomy PM10 powyżej 120 μg/m³), pacjenci doświadczają większych cierpień emocjonalnych25.
Ponadto używanie masek związanych z pandemią COVID-19 może powodować lub zaostrzać łojotokowe zapalenie skóry twarzy1026.
Czynniki związane ze stylem życia
Stres i zmęczenie są istotnymi czynnikami ryzyka dla ŁZS248. Choroba może również zaostrzać się w okresach ogólnego pogorszenia stanu zdrowia8.
Łojotokowe zapalenie skóry jest częstsze u osób nadużywających alkoholu, dotykając 7-11% tej populacji, co stanowi dwukrotność oczekiwanej częstości występowania10.
Badania epidemiologiczne wskazują na związek między nasileniem łojotokowego zapalenia skóry a paleniem tytoniu27.
Czynniki metaboliczne
Istnieją sprzeczne doniesienia na temat związku między ŁZS a wskaźnikiem masy ciała (BMI). Niektóre badania nie wykazują takiej zależności, podczas gdy inne sugerują, że ŁZS wiąże się z wyższym BMI w porównaniu z grupą kontrolną19.
Badania porównawcze przeprowadzone przez Erdogana i wsp. oraz Akbasa i wsp. wykazały, że obwód talii był większy w grupach z łojotokowym zapaleniem skóry w porównaniu z dopasowanymi pod względem wieku, płci i BMI zdrowymi osobami z grupy kontrolnej28.
Nadzór i choroby współistniejące
Nadzór nad łojotokowym zapaleniem skóry jest istotny ze względu na jego związek z różnymi chorobami współistniejącymi i wpływ na jakość życia pacjentów.
Badanie przeprowadzone na 48 630 pracownikach wykazało, że łojotok predysponuje do wystąpienia następujących chorób skóry:13
- Trądzik (OR 3,59; CI 3,18-4,05)
- Torbiele włosowe (OR 1,99; CI 1,25-3,18)
- Trądzik różowaty (OR 1,45; CI 1,17-1,81)
Łojotokowe zapalenie skóry może być wczesnym markerem zakażenia HIV29. U pacjentów z AIDS ŁZS często przebiega ciężko29. Biorąc pod uwagę korelację między nasileniem skórnych objawów ŁZS a klinicznym stadium zakażenia HIV, wiremią i liczbą limfocytów CD4+, ilościowa i jakościowa ocena zmian morfologicznych skóry może służyć jako kryterium prognostyczne przebiegu zakażenia HIV30.
Współwystępowanie łojotokowego zapalenia skóry z depresją, niepokojem i innymi objawami emocjonalnymi ma poważny wpływ na jakość życia pacjentów16. Badanie przeprowadzone na 300 pacjentach z ŁZS (średni wiek 40 lat, 55% mężczyzn) wykazało, że:31
- 84% pacjentów określiło swoją chorobę jako umiarkowaną do ciężkiej
- Prawie połowa pacjentów zgłosiła znaczący negatywny wpływ na swoje samopoczucie emocjonalne (49%) i fizyczne (42%)
Wyzwania w badaniach epidemiologicznych
Pomimo znacznej częstości występowania łojotokowego zapalenia skóry, jego epidemiologia i patogeneza pozostają niedostatecznie zdefiniowane132. Istnieje kilka istotnych wyzwań związanych z badaniami epidemiologicznymi ŁZS:
- Zróżnicowane definicje przypadków i kryteria diagnostyczne, co prowadzi do trudności w porównywaniu wyników badań33
- Łagodny przebieg wielu przypadków, co powoduje, że pacjenci nie zgłaszają się po pomoc medyczną33
- Brak kompleksowych meta-analiz uwzględniających różnice między różnymi populacjami i warunkami32
- Niewystarczająca liczba badań nad wzorcami występowania u dzieci i osób starszych34
Badacze podkreślają potrzebę dalszych badań, aby lepiej zrozumieć globalny rozkład łojotokowego zapalenia skóry, jego zróżnicowanie w różnych populacjach oraz wpływ czynników środowiskowych i praktyk kulturowych na jego częstość występowania35.
Wpływ na jakość życia
Łojotokowe zapalenie skóry ma znaczący wpływ na jakość życia pacjentów, co często jest niedoceniane przez pracowników ochrony zdrowia31. Badania wykazały rozbieżność między postrzeganiem ciężkości choroby przez pacjentów a oceną dokonywaną przez personel medyczny:31
- 84% pacjentów zgłosiło umiarkowane do ciężkich objawy ŁZS, podczas gdy personel medyczny oszacował, że tylko 60% pacjentów ma takie nasilenie objawów
- Prawie połowa pacjentów zgłosiła znaczący negatywny wpływ na swoje samopoczucie emocjonalne (49%) i fizyczne (42%), podczas gdy tylko 32% personelu medycznego oceniającego jakość życia uznało tak głęboki wpływ
W Chinach niemal połowa pacjentów z ŁZS doświadcza poważnych problemów emocjonalnych. Zidentyfikowano kilka czynników ryzyka pogorszenia jakości życia u tych pacjentów, w tym:25
- Ciężkość choroby
- BMI
- Hospitalizacja dermatologiczna
- Poziomy PM10 w otoczeniu
Strategie nadzoru
Ze względu na znaczne rozpowszechnienie i wpływ łojotokowego zapalenia skóry na jakość życia, konieczne są odpowiednie strategie nadzoru. Mogą one obejmować:
- Systematyczne gromadzenie danych epidemiologicznych w różnych populacjach i regionach geograficznych35
- Ocenę wpływu czynników środowiskowych i praktyk kulturowych na częstość występowania ŁZS35
- Standardowe kryteria diagnostyczne w celu zapewnienia spójności między badaniami33
- Monitorowanie chorób współistniejących i czynników ryzyka36
- Comiesięczne liczenie pacjentów z ŁZS w placówkach podstawowej opieki zdrowotnej33
Szczególną uwagę należy zwrócić na nadzór u pacjentów z obniżoną odpornością, zwłaszcza zakażonych HIV, u których ŁZS może być wczesnym markerem zakażenia i pogarsza się wraz z progresją choroby2930.
Podsumowując, łojotokowe zapalenie skóry jest powszechną chorobą zapalną skóry o złożonej epidemiologii, która wymaga dalszych badań w celu pełnego zrozumienia jej globalnego rozkładu, czynników ryzyka i wpływu na jakość życia pacjentów. Lepsze zrozumienie tych aspektów może przyczynić się do opracowania skuteczniejszych strategii profilaktyki i leczenia.
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Materiały źródłowe
- #1 The Global Prevalence of Seborrheic Dermatitis: A Systematic Review and Meta-Analysis – PubMedhttps://pubmed.ncbi.nlm.nih.gov/38958996/
Seborrheic dermatitis is a prevalent chronic inflammatory skin disease, yet its global prevalence, pathogenesis, and epidemiology remain inadequately defined. […] To provide a detailed estimation of the global prevalence of seborrheic dermatitis, analyze demographic variations, and explore differences in various settings. […] The primary outcome was the pooled estimate of global seborrheic dermatitis prevalence. […] 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%]).
- #2 Seborrheic Dermatitis: From Microbiome and Skin Barrier Involvement to Emerging Approaches in Dermocosmetic Treatmenthttps://www.mdpi.com/2079-9284/11/6/208
Seborrheic dermatitis is frequently described as a bimodal condition with two distinct clinical presentations and differing pathophysiological mechanisms: infantile seborrheic dermatitis (ISD) and adolescent/adult seborrheic dermatitis (ASD). […] The global prevalence of SD is 4% (95% CI, 3.58â5.17%), with significant variability (I² = 99.94%). Subgroup analyses showed a higher prevalence in adults (5.64% [95% CI, 4.01â7.27%]) compared to children (3.70% [95% CI, 2.69â4.80%]) and neonates (0.23% [95% CI, 0.04â0.43%]). […] The global prevalence of seborrheic dermatitis, estimated at 3â5%, is likely underestimated due to diagnostic variability across regions. […] The negative impact of SD on quality of life (QoL) is increasingly recognized as a major concern, extending beyond the physical symptoms of itch and flaking to include emotional and social well-being. […] These findings collectively highlight the need for a holistic approach to SD management. Addressing psychological comorbidities, improving patient education, and implementing targeted treatments for symptom control are essential to enhancing patientsâ overall quality of life.
- #3 Seborrheic Dermatitis: Practice Essentials, Background, Pathophysiologyhttps://emedicine.medscape.com/article/1108312-overview
The prevalence rate of seborrheic dermatitis is 3-5%, with a worldwide distribution. In the United States alone, $300 million is spent annually on dandruff over-the-counter treatments. […] Dandruff, the mildest form of this dermatitis, is probably far more common and is present in an estimated 15-20% of the population. […] Seborrheic dermatitis occurs in persons of all races. […] Seborrheic dermatitis is slightly worse in males than in females. […] The usual onset occurs with puberty. It peaks at age 40 years and is less severe, but present, among older people. In infants, it occurs as cradle cap or, uncommonly, as a flexural eruption or erythroderma.
- #4 Seborrheic Dermatitis – StatPearls – NCBI Bookshelfhttps://www.ncbi.nlm.nih.gov/books/NBK551707/
The worldwide prevalence of SD is around 5%, but most of its noninflammatory variant, dandruff, is probably closer to 50%. […] The prevalence of SD is bimodal, with a peak in the first 3 months of life and from adrenarche to a second peak after the fourth decade. […] Furthermore, the Rotterdam Study data analysis found that 14% of middle-aged and elderly adults had SD. […] In patients with HIV-AIDS, however, 35% of those with early HIV infection have SD, and the prevalence reaches 85% in patients with AIDS.
- #5 Seborrheic dermatitis in adolescents and adults – UpToDatehttps://www.uptodate.com/contents/seborrheic-dermatitis-in-adolescents-and-adults
Seborrheic dermatitis has a biphasic incidence, occurring in infants between the ages of 2 weeks and 12 months and later during adolescence and adulthood. The estimated global prevalence of seborrheic dermatitis is approximately 4 percent, with higher rates in adults than in infants and children. […] The prevalence of seborrheic dermatitis is increased among individuals with HIV infection, in whom it may be a presenting sign. The prevalence has been estimated to be around 35 percent among patients with early HIV infection and up to 85 percent among patients with acquired immunodeficiency syndrome (AIDS). […] Patients with parkinsonism frequently present with seborrhea (oily skin) and seborrheic dermatitis, both of which may improve with L-DOPA therapy.
- #6 Seborrheic Dermatitis | 5-Minute Pediatric Consulthttps://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617664/all/Seborrheic_Dermatitis?q=Ketoconazole
Seborrheic dermatitis (SD) is a common, multifactorial skin disease influenced by both host and environmental factors. […] Trimodal distribution: infants, adolescents, and adults 50 years of age. […] Highest prevalence between 2 weeks and 3 months of life. […] Affects approximately 10% of the general population and up to 70% of infants in the first 3 months of life. […] No sex predilection in infants; however, in adolescents and adults, males are affected more commonly than females. […] Seasonal pattern: Prevalence of disease increases in winter months. […] Strong association between Malassezia species, a common commensal organism, and SD.
- #7 Seborrheic dermatitis – wikidochttps://www.wikidoc.org/index.php/Seborrheic_dermatitis
Worldwide, the prevalence of seborrheic dermatitis is estimated to be 11000 cases per 100,000. Prevalence of seborrheic varies among individuals based on the following factors: […] Higher in patients with HIV with 35000 per 100,000 in early diagnosis and 85000 per 100,000 with full blown AIDS […] Higher prevalence seen among those directly exposed to UV radiation. […] The exact incidence of seborrheic dermatitis is unknown. […] Seborrheic dermatitis demonstrates a tri-modal age distribution as follows: […] The first incidence peak is seen in infants around three to four months of age, which usually resolves within 12 months. […] The second incidence peak is seen around puberty. […] The third incidence peak is seen after age 50 with the highest prevalence seen among ages 33-44 years. […] Males are more commonly affected with seborrheic dermatitis than females. […] Seborrheic dermatitis is rarely seen in African Americans. […] If seborrheic dermatitis is seen in this population, it leads to high suspicion of HIV in affected individuals.
- #8 Seborrhoeic dermatitis in adults – National Eczema Societyhttps://eczema.org/information-and-advice/types-of-eczema/seborrhoeic-dermatitis-in-adults/
Seborrhoeic dermatitis affects 4% of the adult population and is more common in men than women. […] The adult form of seborrhoeic dermatitis can develop from puberty but more usually occurs in adulthood prevalence rises sharply over the age of 20, with a peak at 30 years for men and 40 years for women. […] Seborrhoeic dermatitis is not contagious or related to diet, but it may be aggravated by illness, stress, tiredness, changes of season and a general deterioration of health. […] People with an immunodeficiency (especially infection with HIV), a heavy alcohol intake, or a neurological disorder such as Parkinsons disease or stroke, are more prone to it. […] The diagnosis is made from the history and appearance of the skin in the affected area. […] Seborrhoeic dermatitis cannot be cured, because once an individual has become allergic to Malassezia on the skin, exposure to it will always cause a problem.
- #9 Seborrheic Dermatitis | Treatment & Management | Point of Carehttps://www.statpearls.com/point-of-care/28811
The worldwide prevalence of SD is around 5%, but most of its noninflammatory variant, dandruff, is probably closer to 50%. […] SD affects all ethnic groups in all regions globally. […] The prevalence of SD is bimodal, with a peak in the first 3 months of life and from adrenarche to a second peak after the fourth decade. […] In Australian preschool children, SD prevalence was approximately 72% at 3 months, then fell rapidly with an overall incidence of 10%. […] Furthermore, the Rotterdam Study data analysis found that 14% of middle-aged and elderly adults had SD. […] In patients with HIV-AIDS, however, 35% of those with early HIV infection have SD, and the prevalence reaches 85% in patients with AIDS.
- #10 Seborrhoeic dermatitis – Wikipediahttps://en.wikipedia.org/wiki/Seborrhoeic_dermatitis
Seborrhoeic dermatitis affects 1 to 5% of the general population. It is slightly more common in men, but affected women tend to have more severe symptoms. The condition usually recurs throughout a person’s lifetime. Seborrhoeic dermatitis can occur in any age group but often occurs during the first three months of life then again at puberty and peaks in incidence at around 40 years of age. It can reportedly affect as many as 31% of older people. Seborrhoeic dermatitis is more common in African-Americans. […] Severity is worse in dry climates as well as hot weather, as dry skin can exacerbate the condition. COVID-19 related mask usage may also cause or exacerbate facial seborrhoeic dermatitis. […] Individuals who are immunocompromised have an increased risk of seborrhoeic dermatitis. Conditions that are associated with increased rates of seborrhoeic dermatitis include individuals with HIV, Hepatitis C, alcoholic pancreatitis, Parkinson’s disease, and alcohol abuse. Seborrhoeic dermatitis is common in people with alcoholism, between 7 and 11 percent, which is twice the normal expected occurrence.
- #11 Differential microRNA profiles in elderly males with seborrheic dermatitis | Scientific Reportshttps://www.nature.com/articles/s41598-022-24383-3
Seborrheic dermatitis (SD) is one of the most common skin diseases characterized by inflammatory symptoms and cell proliferation, which has increased incidence in patients older than 50 years. […] The incidence of SD in males is approximately threefold higher than that in females, and its prevalence increases in patients aged 50 years. […] Previous studies have also shown that the prevalence of SD in the elderly is consistently higher than that in the general population and has been reported to be as high as 31%. […] SD is a common chronic inflammatory skin disease worldwide. […] The substantially regulated miRNAs may not be specific to SD but may also be commonly represented in other inflammatory skin diseases, such as psoriasis and atopic dermatitis. […] To our knowledge, this is the first study to report the DEM profiles and their potential targets in SD. […] The results from this group may not be appropriate to apply to the general population. […] Nevertheless, our results provide a profound first step in elucidating the pathogenesis of SD because elderly men account for a major proportion of SD patients.
- #12 Avens Publishing Group – Seborrheic Dermatitis and Dandruff: A Comprehensive Reviewhttps://www.avensonline.org/fulltextarticles/JCID-2373-1044-03-0019.html
SD is a common dermatological disorder in the United States and worldwide. Its incidence peaks during three age periods – in the first three months of life, during puberty, and in adulthood with an apex at 40 to 60 years of age. In infants up to three months of age, SD involves the scalp (termed cradle cap), the face, and diaper area. Incidence can be up to 42%. In adolescents and adults, SD affects the scalp and other seborrheic areas on the face, upper chest, axillae, and inguinal folds. Incidence is 1-3% of the general adult population. Men are affected more frequently than women (3.0% vs. 2.6%) in all age groups, suggesting that SD may be associated with sex hormones such as androgens. No apparent differences were observed in SD incidence between ethnic groups. SD is also associated with neurological disorders and psychiatric diseases, including Parkinson’s disease, neuroleptic induced parkinsonism, tardive dyskinesia, traumatic brain injury, epilepsy, facial nerve palsy, spinal cord injury and mood depression, chronic alcoholic pancreatitis, hepatitis C virus, and in patients with congenital disorders such as Down syndrome. Furthermore, seborrhea-like dermatitis of the face may also develop in patients treated for psoriasis with psoralen and ultraviolet A (PUVA) therapy.
- #13 Prevalence and Associated Diseases of Seborrheic Skin | CLEPhttps://www.dovepress.com/prevalence-and-associated-diseases-of-seborrheic-skin-in-adults-peer-reviewed-fulltext-article-CLEP
Seborrhea is a skin condition characterized by abundant production of sebum associated with typical dermatological conditions such as rosacea and acne. Little is known about the prevalence of seborrhea and the frequency of concurrent skin diseases in the general population. […] To investigate the epidemiology and comorbidity of seborrhea in the adolescent and adult working population. […] A total of 48,630 employees were examined. About 6.0% showed seborrhea (6.6% in men, 5.4% in women). […] Seborrhea strongly predicted acne (OR 3.59; CI 3.18 4.05), trichilemmal cysts (OR 1.99; CI 1.25 3.18) and rosacea (OR 1.45; CI 1.17 1.81). […] Regression analyses controlling for age, gender and phototype confirmed significant associations of seborrhea with acne and rosacea. […] Only a minor proportion of the working population shows meaningful seborrheic skin. However, this condition predicts distinct skin diseases and thus needs attention, in particular, with respect to consulting and secondary prevention.
- #14 A Comprehensive View of Seborrhoeic Dermatitis: Epidemiology, Symptoms, and Causes | Open Access Journalshttps://www.rroij.com/open-access/a-comprehensive-view-of-seborrhoeic-dermatitis-epidemiology-symptoms-and-causes.php?aid=93102
Seborrhoeic dermatitis influences 1%-5% of everybody. […] Men are slightly more likely to be affected, but women typically experience more severe symptoms. […] The condition for the most part repeats all through an individual’s lifetime. […] Seborrhoeic dermatitis can occur at any age, but the majority of cases begin during puberty and peak around 40 years of age. […] It is said to affect up to 31% of older people. […] Seriousness is more regrettable in dry environments.
- #15 The Global Prevalence of Seborrheic Dermatitis: A Systematic Review and Meta-Analysis – PubMedhttps://pubmed.ncbi.nlm.nih.gov/38958996/
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%]). […] This comprehensive meta-analysis provides a detailed estimation of the global prevalence of seborrheic dermatitis, highlighting significant variability across different demographics and settings.
- #16 Clinical characteristics and quality of life in seborrheic dermatitis patients: a cross-sectional study in China | Health and Quality of Life Outcomes | Full Texthttps://hqlo.biomedcentral.com/articles/10.1186/s12955-020-01558-y
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). […] The etiology of SD is complex, and may be associated with several factors or internal diseases. It also has high incidence and prevalence (1 to 3% in the immunocompetent adult population, 3 to 5% in young adults, and 40 to 80% in HIV-positive individuals). […] An Asian survey has shown that the prevalence of SD was 2.66, 2.85, 17.16 and 26.45% in Macao, Guangzhou, Malaysia and Indonesia, respectively. […] Patients with SD have scaling scalps, and erythematous patches on the eyebrows, eyelids, nasolabial creases, lips, ears and sternal area. These symptoms affect patients social activities. SD co-occurs with depression, anxiety and other emotional symptoms, and has serious passive effects on patients Quality of Life (QoL).
- #17 Clinical characteristics of seborrheic dermatitis in HIV-infected patients – Evdokimov – Epidemiology and Infectious Diseases. Current Itemshttps://journals.eco-vector.com/2226-6976/article/view/287452
Objective. To identify the clinical characteristics of seborrheic dermatitis (SD) in HIV-infected patients according to HIV infection stage, immune status, and viral load. […] A total of 401 patients with SD were followed up. A study group included 198 (49.4%) HIV-infected patients; a comparison group consisted of 203 (50.6%) HIV-negative patients. […] The progression/exacerbation of SD at the stage of secondary diseases was noted in 140 (76.5%) patients of the study group. […] At the beginning of the study, obvious immunodeficiency was seen in patients at the stage of secondary diseases (the CD4+ lymphocyte counts was less than 350 cells/ml in 101 patients), while the viral load was more than 103 copies for HIV RNA; 71 patients were noted to have moderate-to-severe and severe SD requiring continuous drug therapy.
- #18 Infantile Seborrheic Dermatitis | MDedgehttps://mdedge.com/cutis/article/67364/contact-dermatitis/infantile-seborrheic-dermatitis
Seborrheic dermatitis (SD) is one of the most common dermatoses of infancy. […] SD occurs most frequently in infants and adults aged 30 to 60 years. Its prevalence in immunocompetent adults is estimated to be between 1% and 3%. […] The incidence of SD is unusually high among patients with AIDS, ranging from 30% to 83%. […] The occurrence of SD in prepubertal children (aged 2â5 years) is uncommon. […] The etiology of SD is poorly understood. […] Research suggests that SD is not caused by an overgrowth of Malassezia but an abnormal host response. […] The relationship between ISD and infantile AD (IAD) is controversial. […] Recent studies have demonstrated that patients with head and neck AD have immunoglobulin E antibodies to Malassezia furfur, the yeast causative of ISD. […] Severe treatment-resistant SD may be associated with human immunodeficiency virus infection and is common in infants who develop human immunodeficiency virusârelated immune suppression in the first year of life. […] In most instances, the diagnosis of SD is clinically obvious. […] When SD is diagnosed in a prepubertal child, precocious puberty should be suspected.
- #19 JMIR Dermatology – Nutrition, Obesity, and Seborrheic Dermatitis: Systematic Reviewhttps://derma.jmir.org/2024/1/e50143
Seborrheic dermatitis affects approximately 5% of the global population, while its noninflammatory form affects closer to 50% of individuals. […] Seborrheic dermatitis prefers males of all ethnicities and peaks in the first 3 months of life and again at puberty, where it then reaches an apex at 40-60 years and later declines. […] Risk factors for seborrheic dermatitis include immunodeficiency, neurological diseases including Alzheimer and Parkinson disease, increased sebaceous gland activity, and exposures to drug treatment, including lithium, immunosuppressants, and dopamine antagonists. […] Some studies demonstrate no relationship between seborrheic dermatitis and BMI; however, a case-control study by Akba et al compared patients with seborrheic dermatitis with age and sex-matched controls and found that seborrheic dermatitis was associated with higher BMI when compared with controls.
- #20 Is It Dandruff or Seborrheic Dermatitis?https://www.uspharmacist.com/article/is-it-dandruff-or-seborrheic-dermatitis
SD affects approximately 3% to 5% of U.S. citizens, but the incidence is as high as 85% in AIDS patients. Males are more likely to experience SD. It is more common after puberty, although infants may experience a variant of SD known as cradle cap (discussed later). SD generally becomes less common as people age, although many experience exacerbations throughout life. Patients with certain central nervous system disorders may experience increased accumulation of sebum, predisposing them to SD. This includes conditions limiting patient mobility, such as stroke, Parkinsons disease, head injury, cranial nerve palsies, and major truncal paralyses. […] […] […] There is an inherited tendency to experience SD, so those with a close relative with SD are at greater risk. Further, individuals with oily skin, acne, or obesity appear to be predisposed to SD. Those who are stressed or fatigued are at higher risk. Persons who do not bathe or shampoo frequently experience higher rates of SD.
- #21 Seborrheic dermatitis: Causes and treatment â DermNethttps://dermnetnz.org/topics/seborrhoeic-dermatitis
Seborrhoeic dermatitis is a common skin condition affecting 3% to 12% of the population. […] It has a biphasic incidence occurring in infants and in adolescents and adults. […] Prevalence is greatest in young adults and in older people. […] Seborrheic dermatitis is very common among patients of darker skin types. Studies have shown that it is among the five most common diagnoses observed in black patients.
- #22 Seborrheic Dermatitis | MDedge Dermatologyhttps://www.mdedge9-ma1.mdedge.com/dermatology/article/248389/pigmentation-disorders/seborrheic-dermatitis
Seborrheic dermatitis affects patients of all ages: infants, adolescents, and adults. It is among the most common dermatologic diagnoses reported in Black patients in the United States. […] Seborrheic dermatitis is among the most common cutaneous disorders diagnosed in patients with skin of color. Delay in recognition of SD in those with darker skin tones leads to delayed treatment. Seborrheic dermatitis of the face can cause notable postinflammatory pigmentation alteration. Pigmentation changes in the skin further impact quality of life.
- #23 Avens Publishing Group – Seborrheic Dermatitis and Dandruff: A Comprehensive Reviewhttps://www.avensonline.org/fulltextarticles/JCID-2373-1044-03-0019.html
Comparing with SD, dandruff is much more common, and affects approximately 50% of the general adult population worldwide. It is also more prevalent in males than females. Dandruff starts at puberty, reaches peak incidence and severity at the age of about 20 years, and becomes less prevalent among people over 50. Incidence varies between different ethnic groups: in a study in the U.S. and China, dandruff prevalence was 81-95% in African Americans, 66-82% in Caucasians, and 30-42% in Chinese.
- #24 Diagnosis and Treatment of Seborrheic Dermatitis | AAFPhttps://www.aafp.org/pubs/afp/issues/2015/0201/p185.html
Seborrheic dermatitis is a common skin condition in infants, adolescents, and adults. […] Its prevalence is 1% to 3% in the general population and 34% to 83% in immunocompromised persons. […] It has a bimodal distribution, with peaks at two to 12 months of age and in adolescence and early adulthood. […] It is more common in men and is typically more severe in cold and dry climates and during periods of increased stress.
- #25 Clinical characteristics and quality of life in seborrheic dermatitis patients: a cross-sectional study in China | Health and Quality of Life Outcomes | Full Texthttps://hqlo.biomedcentral.com/articles/10.1186/s12955-020-01558-y
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. […] This study investigates the clinical characteristics and QoL of patients with SD in China, and explores factors associated with QoL impairment. […] This study has demonstrated that the presence of SD has a negative effect on QoL, and that disease severity influences QoL in all domains, and in the overall score. […] We found a statistically significant correlation between ambient PM 10 levels and patients QoL in our study. When outdoor air quality worsens (PM 10 levels over 120g/m3), individuals suffer more emotional torture than ever. […] Those who suffer from SD in China experience severe effects on all realms of daily life. We found that disease severity, dermatologic hospitalization and PM 10 level each had negative effects on patients QoL.
- #26https://apcz.umk.pl/JEHS/article/view/45896
Seborrheic dermatitis (SD) is common inflammatory dermatology disease. Its affect up to 3-8% of the population. […] A review of current stage of knowledge on the pathophysiology, epidemiology of Seborrheic Dermatitis. […] The Pathogenesis of Seborrheic dermatitis is not fully understood, the exact molecular process needs to be examined. […] SD is chronic disease with episode of remission and relapse of symptoms. […] The impact of the Covid-19 pandemic and the use of masks on the incidence of Seborrheic Dermatitis.
- #27 RAS Medical Sciencehttp://www.raspublishers.com/articles?id=86
Observational medicine has solved the etiology of a familial seborrheic dermatitis, an allergy to hapten nicotine and allergen tobacco. […] Recently, epidemiological studies show a link of severity of seborrheic dermatitis in tobacco smokers. […] Also, it can be concluded that observational medicine is much faster to solve a skin disease in comparison with epidemiology.
- #28 JMIR Dermatology – Nutrition, Obesity, and Seborrheic Dermatitis: Systematic Reviewhttps://derma.jmir.org/2024/1/e50143
Erdogan et al and Akbas et al conducted case-control studies comparing waist circumference in patients with seborrheic dermatitis to age, sex, and BMI-matched healthy controls. […] Both found that waist circumference was higher in the seborrheic dermatitis groups. […] The negative consequences of a Western diet, alcohol use, obesity, and the benefits of fruit consumption are well known; however, to fully understand their specific relationships to seborrheic dermatitis, further cohort or interventional studies are needed.
- #29 Seborrhoeic Dermatitis | Doctorhttps://patient.info/doctor/seborrhoeic-dermatitis-pro
Globally, seborrhoeic dermatitis occurs in 1-5% of the general population. This increases in the immunocompromised, with prevalence rates reported at 34-83%, and it has been suggested that it could be an early marker of HIV infection. In individuals with AIDS, the condition is often severe. […] SD is more common in males than in females, which is thought to be due to the effect of androgen on production of sebum. Peak incidence is in infants, in adolescents and in young adults: however, it can occur at any age. It is seen throughout the world.
- #30 Clinical characteristics of seborrheic dermatitis in HIV-infected patients – Evdokimov – Epidemiology and Infectious Diseases. Current Itemshttps://journals.eco-vector.com/2226-6976/article/view/287452
Taking into account the correlation of the intensity of cutaneous manifestations of SD with the clinical stage of HIV infection, viral load, and CD4+ lymphocyte counts, the quantitative and qualitative assessment of the recording of morphological alterations of the skin can serve as a prognostic criterion for the course of HIV infection.
- #31https://link.springer.com/article/10.1007/s13555-024-01288-9
The survey comprised responses from 300 patients with SD, with an average age of 40 years and a male majority (55%). […] Most patients described their SD severity as moderate (71%) or severe (13%). […] However, although 84% of patients reported their condition as moderate-to-severe, HCPs estimated only 60% of patients as having moderate-to-severe SD. […] Nearly half of patients reported significant negative impacts on their emotional (49%) and physical (42%) well-being due to SD, whereas only 32% of HCPs assessing quality of life acknowledged such profound effects. […] This study sheds light on the significant burden of SD, challenging the misconception of SD as a superficial skin issue and revealing areas of potential gaps between patient experiences and HCP perceptions. […] These insights emphasize the critical need for comprehensive treatment approaches that address not only the clinical symptoms of SD but also its broader psychological and social ramifications, fostering strategies aimed at breaking the cycle of stress and symptom exacerbation to improve overall patient quality of life.
- #32 Study Highlights Global Prevalence of Patients with Seborrheic Dermatitishttps://www.hcplive.com/view/study-highlights-global-prevalence-patients-seborrheic-dermatitis
These data suggest the necessity of additional research to explore seborrheic dermatitis as well as its variations among many diverse groups and populations. […] Seborrheic dermatitis may be more prevalent among adults than children, according to new findings, and geographic analyses suggest the diseases highest prevalence is in South Africa and lowest is within India. […] Polaskey et al. noted that despite seborrheic dermatitiss burden and common occurrence within the clinical area, the conditions pathogenesis and epidemiology continue to be less well understood. […] The investigators also commented that an overall accurate impression of the diseases prevalence around the world had remained somewhat elusive. […] No comprehensive meta-analysis has been conducted, to our knowledge, that thoroughly addresses the global prevalence of seborrheic dermatitis, especially one that accounts for variations across different settings, Polaskey and colleagues wrote.
- #33 Seborrhoeic dermatitis – Clinical review | GPonlinehttps://www.gponline.com/seborrhoeic-dermatitis-clinical-review/dermatology/dermatology/article/1181296
Seborrhoeic dermatitis (SD) is a classic inflammatory dermatosis – it is common and chronic, with multiple treatment options but no cure. […] Estimates of SD prevalence and incidence are hindered by many cases being mild and poor case definition, so probably underestimate the true figure. SD is noted to be especially prevalent in those with HIV/AIDS and chronic neurodegenerative disorders, such as Parkinson’s disease. […] The prevalence of SD is not currently determined. Consider a monthly count of patients seen with the condition at your practice.
- #34https://www.medicaljournals.se/acta/content/html/10.2340/00015555-1315
Dandruff, or pityriasis capitis, is the most common symptom of seborrhoeic dermatitis (1). […] Although it is considered a very common condition, no published epidemiological study evaluating the frequency of dandruff could be found in the literature. […] The prevalence of dandruff in the French population was high. […] Some studies were performed on the prevalence of seborrhoeic dermatitis in adults, with the following results: 2.1% in France (2), 11.6% in the USA (only 2.8% clinically significant) (3). […] A British study showed an incidence of 54 per 100,000 population over the years 2001 to 2005 (4). […] Dandruff is considered as very frequent, and appears to be more frequent among men than women and more frequent among young people than older people. […] A study suggested that seborrhoeic dermatitis could be more frequent among elderly people, especially in case of dependency, but did not report specific data on dandruff (7). […] Dandruff is the most common symptom of seborrhoeic dermatitis.
- #35 Study Highlights Global Prevalence of Patients with Seborrheic Dermatitishttps://www.hcplive.com/view/study-highlights-global-prevalence-patients-seborrheic-dermatitis
Overall, the investigators concluded their research with a review of 1,574 articles, including a total of 121 studies that had evaluated a total of 1,260,163 study subjects. […] They reported that the global prevalence of the skin condition had been shown to be 4.38% (95% CI, 3.58%-5.17%), though they did also find that there had been substantial levels of heterogeneity observed among the study populations (I2 = 99.94%). […] In their subgroup analyses, the research team found that adult patients had been shown to have higher prevalence of seborrheic dermatitis (5.64% [95% CI, 4.01%-7.27%]) versus the prevalence observed among neonates (0.23% [95% CI, 0.04%-0.43%]) and children (3.70% [95% CI, 2.69%-4.80%]). […] The team also noted geographic distinctions among those studied, highlighting the fact that South Africa had the highest level of disease prevalence at 8.82% (95% CI, 3.00%-14.64%) and India maintained the lowest rate of prevalence at 2.62% (95% CI, 1.33%-3.92%). […] These findings underscore the need for further research to better understand the global distribution of seborrheic dermatitis, its variations across diverse populations, and the influence of environmental factors and cultural practices on its prevalence, they wrote.
- #36https://link.springer.com/article/10.1007/s13555-024-01288-9
Seborrheic dermatitis (SD) is a common, chronic inflammatory skin disease, but the physical and emotional burden of patients with SD experience has not been well characterized. […] Epidemiological understanding of SD remains limited. […] SD is associated with significant global impact, markedly diminishing quality of life for those with the disease. […] This impact disproportionately affects specific demographics, such as women, younger individuals, those with higher education levels, and patients with scalp lesions, highlighting the diseases uneven impact across population segments. […] Despite increasing recognition of SD and its impact on quality of life, significant gaps persist in the literature, particularly regarding the potential disparity or harmony between patient experiences and healthcare provider (HCP) perceptions of the diseases burden.