Materiały źródłowe

• #1 Seborrheic Dermatitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551707/

  Seborrheic dermatitis (SD) is a common inflammatory skin disease presenting with a papulosquamous morphology in areas rich in sebaceous glands, particularly the scalp, face, and body folds. […] The proposed Mechanisms for the Pathogenesis of SD include: disruption of the skins microbiota, an impaired immune reaction to Malassezia spp. associated with a diminished T-cell response and activation of complement, the increased presence of unsaturated fatty acids on the skin surface, disruption of cutaneous neurotransmitters, abnormal shedding of keratinocytes, and epidermal barrier disturbances associated with genetic factors. […] The role of Malassezia spp. also includes the degradation of sebum and consumption of saturated fatty acids, disrupting the lipid balance on the skin surface. Further evidence for the involvement of Malassezia spp. includes their isolation from SD lesions and the significant resolution of SD with antifungal treatment.

• #2 Seborrheic Dermatitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2888552/

  Seborrheic dermatitis is a common chronic inflammatory skin condition, characterized by scaling and poorly defined erythematous patches. […] Although its pathogenesis is not completely understood, some postulate that the condition results from colonization of the skin of affected individuals with species of the genus Malassezia (formerly, Pityrosporum). […] The pathogenesis of seborrheic dermatitis is not completely understood, but there seems to be a strong association with skin colonization with yeasts of the genus Malassezia. […] These yeasts are present on the skin of affected individuals, and antifungal therapy that decreases the number of Malassezia organisms present has been shown to be effective in the treatment of seborrheic dermatitis. […] The fact that there is a preponderance of disease in sebum-rich areas has led to the idea that fungal metabolites react with triglycerides released from sebaceous glands, producing an inflammatory mediator. […] Another theory is that the lipid layer of the fungus leads to keratinocyte production of proinflammatory cytokines, causing inflammation and the skin eruption.

• #3 Seborrheic Dermatitis – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/dermatitis/seborrheic-dermatitis

  Seborrheic dermatitis is a common inflammatory condition of skin regions with a high density of sebaceous glands (eg, face, scalp, sternum). […] The pathogenesis is unclear, but activity of the condition has been linked to the population size of Malassezia yeasts found on the skin and to the inflammatory reaction to the yeast. […] Seborrheic dermatitis may be more common and more severe among patients with neurologic disorders (especially Parkinson disease), possibly due to changes in the activity of sebaceous glands. […] It is also more prevalent and severe among those with HIV/late-stage HIV, likely because of an imbalance of T-cell pro- and anti-inflammatory responses.

• #4 Seborrheic Dermatitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1108312-overview

  Seborrheic dermatitis is linked to Malassezia, immunologic abnormalities, and activation of complement. Its severity ranges from mild dandruff to exfoliative erythroderma. […] Malassezia organisms are probably not the cause of seborrheic dermatitis but a cofactor linked to a T-cell depression, increased sebum levels, and an activation of the alternative complement pathway. […] Seborrheic dermatitis is associated with normal levels of Malassezia but an abnormal immune response. Helper T cells, phytohemagglutinin and concanavalin stimulation, and antibody titers are depressed compared with those of control subjects. […] The contribution of Malassezia species to seborrheic dermatitis may come from its lipase activity releasing inflammatory free fatty acids and from its ability to activate the alternative complement pathway. […] The exact pathophysiology remains unclear. Malassezia organisms are probably not the cause but are a cofactor linked to a T-cell depression, increased sebum levels, and an activation of the alternative complement pathway.

• #5 Seborrheic Dermatitis: An Overview | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0701/p125.html

  Seborrheic dermatitis affects the scalp, central face, and anterior chest. […] Despite the high prevalence of seborrheic dermatitis, little is known about its etiology. However, several factors (e.g., hormone levels, fungal infections, nutritional deficits, neurogenic factors) are associated with the condition. The possible hormonal link may explain why the condition appears in infancy, disappears spontaneously, then reappears more prominently after puberty. A more causal link seems to exist between seborrheic dermatitis and the proliferation of Malassezia species (e.g., Malassezia furfur, Malassezia ovalis) found in normal dimorphic human flora. […] A causal relationship is implied because of the ability to isolate Malassezia in patients with seborrheic dermatitis and by its therapeutic response to antifungal agents.

• #5 Seborrheic Dermatitis: An Overview | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0701/p125.html

  An altered essential fatty acid pattern may be important in the pathogenesis of infantile seborrheic dermatitis. […] A neurogenic theory for the development of seborrheic dermatitis may account for its association with parkinsonism and other neurologic disorders, including postcerebrovascular accidents, epilepsy, central nervous system trauma, facial nerve palsy, and syringomyelia induced by neuroleptic drugs with extrapyramidal effects.

• #6 The Diagnosis and Management of Seborrheic Dermatitis | CCID

  https://www.dovepress.com/an-overview-of-the-diagnosis-and-management-of-seborrheic-dermatitis-peer-reviewed-fulltext-article-CCID

  Seborrheic dermatitis (SD) is a common chronic inflammatory skin disorder that mostly affects young adults in areas rich in sebaceous glands (scalp, face, and trunk). […] In adults, several environmental triggers are likely to promote SD development, along with fungal colonization by Malassezia spp., sebaceous gland activity, as well as immunosuppression, endocrine, neurogenic and iatrogenic factors. […] SD pathogenesis is multifactorial and still poorly delineated. Although some environmental triggers (eg, low temperature and humidity in winter) are likely to promote its development, several other factors, including fungal colonization by Malassezia spp. (formerly called Pityrosporum ovale), sebaceous gland activity, as well as immunosuppression, endocrine, neurogenic and iatrogenic factors, have been postulated.

• #6 The Diagnosis and Management of Seborrheic Dermatitis | CCID

  https://www.dovepress.com/an-overview-of-the-diagnosis-and-management-of-seborrheic-dermatitis-peer-reviewed-fulltext-article-CCID

  In children, common early occurrence in the first trimester suggests the role of excessive sebaceous gland activity from maternal hormones, along with cutaneous microbiome alterations, including Malassezia spp., Staphylococcus spp., Streptococcus spp., and Corynebacterium spp. […] Several experimental in vitro and in vivo investigations have shown excessive sebum excretion (ie, hyperseborrhea) and/or altered barrier function, with a consequent increase in transepidermal water loss (TEWL) and/or skin dysbiosis in SD-affected areas. […] The mechanisms underlying sebum changes in bilateral seborrhea in unilateral Parkinsonism could be regulated endocrinologically rather than neurologically. […] The increased sebum production rate, coupled with reduced mimic facial movements, may provide permissive conditions for Malassezia proliferation.

• #7 A Comprehensive Pathophysiology of Dandruff and Seborrheic Dermatitis – Towards a More Precise Definition of Scalp Health | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-1382

  Malassezia are commensal scalp yeasts that are generally regarded as an etiological factor in D/SD. […] A potential etiopathological mechanism involves the lipolytic release of the fatty acid moieties from the parent sebaceous triglycerides by lipase activity originating from secreted Malassezia lipases; free fatty acids, especially unsaturated ones, can induce the inflammation and hyperproliferation known to be components of D/SD leading to the commonly observed signs and symptoms associated with the conditions. […] The outward manifestations of D/SD discussed above are the result of epidermal structural and functional disruption. […] These structural variations at the cellular level result in a SC barrier that is functionally impaired. […] Effective therapeutic D/SD treatments not only alleviate the signs and symptoms of the condition, but result in normalization of the structure and function of the skin as well.

• #7 A Comprehensive Pathophysiology of Dandruff and Seborrheic Dermatitis – Towards a More Precise Definition of Scalp Health | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-1382

  The pathophysiological model that is emerging is based on the established etiological phases of Malassezia metabolism initiating the inflammatory cascade, resulting in scalp skin hyper-proliferation and incomplete corneocyte differentiation that yields an impaired SC barrier. […] These observations, in turn, have led to probing specific molecular mechanisms in the skin, which established the inflammatory nature of the condition, the poor synchronization of proliferation and differentiation and the relatively ineffective barrier function.

• #7 A Comprehensive Pathophysiology of Dandruff and Seborrheic Dermatitis – Towards a More Precise Definition of Scalp Health | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-1382

  Despite an increasing knowledge of dandruff and seborrheic dermatitis (D/SD), the pathophysiological understanding is still incomplete but suggests a role of Malassezia yeasts in triggering inflammatory and hyper-proliferative epidermal responses. […] A comprehensive review of the pathophysiological changes in the stratum corneum (SC) in these conditions at the macro (signs and symptoms), micro (physiological structure and function) and biomolecular strata may enable a precise and more complete determination of the condition of the scalp and also the therapeutic responses to treatment leading to restoration of homeostasis. […] The 4 pathophysiological phases and the 3 informational strata can be considered orthogonal views of the total D/SD data. By combining these views, an organizational model emerges which allows each independent measure to be categorized by its pathophysiological phase and informational stratum.

• #8 Seborrheic Dermatitis: From Microbiome and Skin Barrier Involvement to Emerging Approaches in Dermocosmetic Treatment

  https://www.mdpi.com/2079-9284/11/6/208

  Malassezia fungi predominantly colonize seborrheic areas of the skin, where they utilize both saturated and unsaturated fatty acids for their growth. Because they lack the genes needed to produce fatty acids themselves, Malassezia species rely on fatty acids supplied by the host. These fungi release enzymes that break down the lipids found on the skin’s surface, producing unsaturated free fatty acids that can trigger skin inflammation. […] The strong correlation between yeast count and disease severity, as well as the observed improvement in affected skin after antifungal treatment, points to Malassezia’s significant role in the pathogenesis of SD. However, emerging evidence indicates that immune dysregulation and skin barrier function are likely central to SD pathogenesis, with Malassezia playing a secondary associated role.

• #8 Seborrheic Dermatitis: From Microbiome and Skin Barrier Involvement to Emerging Approaches in Dermocosmetic Treatment

  https://www.mdpi.com/2079-9284/11/6/208

  Seborrheic dermatitis (SD) is a chronic inflammatory skin disease that primarily affects sebaceous-rich areas such as the scalp, face, and upper trunk. While the precise etiology remains multifactorial, the role of the skin microbiome, particularly the proliferation of Malassezia species, and alterations in the skin barrier function are critical in its pathogenesis. Disruption of the skin barrier, characterized by increased transepidermal water loss (TEWL) and reduced production of epidermal lipids, creates a favorable environment for microbial overgrowth and inflammation. Recent insights highlight the interplay between the impaired barrier function, immune responses, and the skin microbiome in perpetuating the disease. […] The precise pathophysiology of seborrheic dermatitis remains unclear due to its multifaceted and complex etiology. However, three key interrelated factors contribute to its development: individual susceptibility caused by an imbalanced immune response leading to inflammation, cutaneous microbial dysbiosis characterized by notable colonization of Malassezia species, and a compromised epidermal barrier. Of these factors, the role of Malassezia has been the most thoroughly studied, largely due to its presence in lesional skin and the positive clinical response of SD to antifungal treatments.

• #8 Seborrheic Dermatitis: From Microbiome and Skin Barrier Involvement to Emerging Approaches in Dermocosmetic Treatment

  https://www.mdpi.com/2079-9284/11/6/208

  The skin barrier acts as the first line of defense against environmental insults, and its impairment is a critical factor in the pathogenesis of various forms of dermatitis. […] Research has demonstrated a correlation between skin barrier dysfunction and the prevalence of seborrheic dermatitis. […] Individuals with seborrheic dermatitis exhibit changes in abundance and types of ceramides that compose the stratum corneum, which may compromise the structural integrity of the skin barrier, leading to hyperproliferation, abnormal keratinization, and flaking. […] In conclusion, skin barrier impairment plays a crucial role in the development and exacerbation of seborrheic dermatitis. The interplay between barrier dysfunction, microbial colonization, and inflammatory responses highlights the need for therapeutic strategies that not only target inflammation but also focus on restoring and maintaining skin barrier integrity. Understanding these mechanisms is essential for developing effective treatments for seborrheic dermatitis and improving patient outcomes.

• #9 Seborrheic dermatitis and its relationship with Malassezia spp

  http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0123-93922021000200120

  Malassezia species appear to contribute by triggering the skin innate immunity through complex interactions between fungal cells and virulence factors. This ends up in increasing the production of lipases, inducing an inflammatory response by releasing oleic acid and arachidonic acid, and producing bioactive components from sebum lipids. […] In an inflammation scenario, Malassezia can generate the process associated with its overgrowth by three main mechanisms. First, causing evident damage to the epidermal barrier through the production of lipases and phospholipases. […] Lipases hydrolyze triglycerides present in human sebum, producing the release of free unsaturated fatty acids, such as oleic acid and arachidonic acid, which are capable of crossing the epidermal barrier. These metabolites play a crucial role in the initiation of the inflammatory response, causing hyperproliferation and aberrant differentiation of keratinocytes, resulting in abnormalities in the corneum stratum such as parakeratosis, intracellular lipid droplets and abnormal development of stratum corneum cells.

• #9 Seborrheic dermatitis and its relationship with Malassezia spp

  http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0123-93922021000200120

  Secondly, an increase in the local immune response is evidenced through the production of different pro-inflammatory cytokines by the keratinocytes, such as IL-1, IL-6, IL-8, and TNF-, thus prolonging the inflammatory response triggered by these yeasts. […] Thirdly, a sensitization to cross-reactive allergens produced by Malassezia can be evidenced. According to this model, there is an increased inflammatory response against the exposure to Malassezia spp. by the action of allergens released by the microorganism. […] In the process of the interaction between two organisms, there are determinants specific of the immune response type established to the antigenic exposure. In the case of Malassezia spp., the maturation of dendritic cells derived from the monocytic line is the main cellular component that is responsible for the antigenic presentation and induction of a predominantly Th2-type lymphocytic response. […] The authors thank Dr. Elizabeth Castaeda for the critical review of this manuscript.

• #10 Etiopathogenesis of seborrheic dermatitis – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/etiopathogenesis-of-seborrheic-dermatitis/

  Seborrheic dermatitis (SD) is a common inflammatory disorder of the skin, characterized by erythema covered with greasy-looking scales and seen over areas rich in sebaceous glands-namely, the scalp, face, chest, back and flexural areas. Though much remains to be learned, there is increasing understanding of the etiopathogenesis of seborrheic dermatitis. This should eventually lead to more effective management of the disease. […] It has been suggested that the increased sebum levels in patients of Parkinsons disease have permissive effect on the growth of Malassezia. It may be concluded that seborrhea may be a predisposing factor but is not the primary etiological factor for seborrheic dermatitis. […] Schuster proposed that the organism Malassezia furfur or its yeast form, Pityrosporum ovale, plays an etiological role in SD. The organism is increased in number in SD and can be cultured from the lesions. Experimental infection with the organism causes the disease. Patients with dandruff have high antibody titers to Malassezia compared with controls. A good therapeutic response to antipityrosporal drugs proves the point. Improvement in the disease corresponds with a reduction in the number of Malassezia, while recolonization results in disease recurrence.

• #10 Etiopathogenesis of seborrheic dermatitis – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/etiopathogenesis-of-seborrheic-dermatitis/

  How Malassezia yeasts initiate the inflammation of seborrheic dermatitis is not clear. They or their byproducts may cause inflammation by inducing cytokine production by keratinocytes or through involvement of Langerhans cells and T-lymphocyte activation. However, the occurrence of SD in early HIV infection, where the cell-mediated immunity is impaired, goes against the hypothesis that SD is mediated by T-lymphocyte activation by Pityrosporum ovale. […] The increased prevalence of seborrheic dermatitis in HIV-positive patients also supports the hypothesis that seborrheic dermatitis has a strong immunological basis. […] Though the relationship between seborrheic dermatitis and Malassezia yeasts is not yet completely understood, these studies support the postulation that strong skin colonization with P. ovale in seborrheic dermatitis is due to altered cell-mediated immunity and that the development of seborrheic dermatitis depends upon the way the patients immune system reacts to antigens derived from P. ovale.

• #10 Etiopathogenesis of seborrheic dermatitis – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/etiopathogenesis-of-seborrheic-dermatitis/

  The cause of SD is yet to be resolved. Until then, the choice of therapy in SD will be between antimycotics, topical steroids, sebostatics or their combinations. The future may see more studies with topical immunomodulators or other nonsteroidal agents like metronidazole, whose mechanism of action is yet to be elucidated.

• #11 New Insights into the Etiopathogenesis of Seborrheic Dermatitis

  https://symbiosisonlinepublishing.com/dermatology/dermatology52.php

  The seborrheic dermatitis measures support the inclusion of this pathology in the broad group of inflammatory dermatoses such as psoriasis, atopic dermatitis and acne presenting with different triggering events but sharing the pathophysiology of inflammation, proliferation and skin barrier impairment. […] The aberrant production of Malassezia phospholipases on the skin leads to epidermal lipid removal, epidermal barrier function disruption, and seborrheic dermatitis development when sebum production is constitutionally decreased. […] The fatty acids generated by Malassezia lipase induce skin inflammation leading to seborrheic dermatitis development. […] The presence of host susceptibility factors permitting the transition of Malassezia furfur to its pathogenic form may be associated with immune response and inflammation.

• #11 New Insights into the Etiopathogenesis of Seborrheic Dermatitis

  https://symbiosisonlinepublishing.com/dermatology/dermatology52.php

  The increase in natural killer cells (NK1+), CD16+ cells and inflammatory interleukins as well as complement activation in lesional skin as compared to non-lesional skin and in skin of healthy controls suggests an augmented inflammatory response in seborrheic dermatitis patients. […] The immunoenzymatic examination of the concentrations of selected inflammatory factors in 36 seborrheic dermatitis patients demonstrates statistically significantly higher levels of interleukin-2 and gamma interferon in these patients than in the control subjects and proves the role of these cytokines in the pathogenesis of seborrheic dermatitis. […] The specific molecular mechanisms in the skin establish the inflammatory nature of the disease, the poor synchronization of proliferation and differentiation and the relatively ineffective barrier function.

• #11 New Insights into the Etiopathogenesis of Seborrheic Dermatitis

  https://symbiosisonlinepublishing.com/dermatology/dermatology52.php

  Sebaceous glands contribute to skin barrier function and their alteration may play a role in the pathogenesis of seborrheic dermatitis and other common skin diseases such as acne vulgaris, atopic dermatitis, psoriasis, and rosacea. […] There is a significant increase in the levels of the biological markers cathepsin S, proteinase-activated receptor 2 and histamine patients with seborrheic dermatitis which correlate with clinical parameters. […] The role of oxidative stress for the etiopathogenesis of seborrheic dermatitis is comparatively examined in 54 patients and 54 healthy volunteers.

• #11 New Insights into the Etiopathogenesis of Seborrheic Dermatitis

  https://symbiosisonlinepublishing.com/dermatology/dermatology52.php

  Seborrheic dermatitis represents a chronic, widespread skin disease that is considered a multifactorial disorder influenced, in part, by Malassezia spp. opportunistic activities as well as by various endogenous and exogenous factors. […] Much controversy remains regarding the pathogenesis of seborrheic dermatitis and its classification in the spectrum of cutaneous diseases as a form of dermatitis, a fungal disease, or an inflammatory disease, closely related with psoriasis. […] Various intrinsic and environmental factors, such as sebaceous secretions, skin surface fungal colonization, individual susceptibility, and interactions between these factors play a pathogenetic role in seborrheic dermatitis. […] There are three principal factors that play a role in the etiology of seborrheic dermatitis: sebaceous gland secretion, alteration in colonization and metabolism of cutaneous microflora (Malassezia spp.), as well as individual susceptibility and host response.

• #12 Seborrhoeic dermatitis in adults – National Eczema Society

  https://eczema.org/information-and-advice/types-of-eczema/seborrhoeic-dermatitis-in-adults/

  Seborrhoeic dermatitis is believed to be an inflammatory reaction related to an overgrowth of normal skin inhabitants Malassezia yeasts (Malassezia furfur, also known as Pityrosporum ovale). […] The yeasts are part of normal skin flora, but for an unknown reason they trigger seborrhoeic dermatitis in certain individuals. […] 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. […] The only way to keep it under control is to use anti-yeast treatments, which will suppress seborrhoeic dermatitis but not eradicate it. […] The major reservoir for the yeast is the scalp, so a medicated anti-yeast shampoo should be used. […] The important message is that long-term treatment is needed to keep this condition at bay. If it recurs, it is not because the treatment has failed it is because of the persistent nature of the condition, due to sensitivity to Malassezia yeasts. Therefore, ongoing treatment with anti-yeast measures is vital.

• #13 Seborrheic Dermatitis: Exploring the Complex Interplay with Malassezia

  https://www.mdpi.com/1422-0067/26/6/2650

  Understanding the relationship between Malassezia and the patient’s inadequate immune response is essential in the pathogenesis of SD. Although Malassezia is a ubiquitous commensal organism on the skin, the distinguishing element in patients with SD is the exaggerated or aberrant immune reactivity towards this yeast. The immune dysregulation serves as both the initiating and perpetuating factor for the chronic inflammation and clinical manifestations. […] The immune system of individuals with HIV is ineffective in eradicating the yeast due to immune dysregulation, causing excessive yeast proliferation and marked inflammation. […] This review aims to examine the role of the immune system in SD, focusing on how alterations in the immune response can facilitate the colonization and proliferation of Malassezia.

• #13 Seborrheic Dermatitis: Exploring the Complex Interplay with Malassezia

  https://www.mdpi.com/1422-0067/26/6/2650

  Seborrheic dermatitis (SD) is a chronic inflammatory skin condition often involving the sebaceous-rich areas, characterized by erythematous scaly lesions. It is frequently observed in individuals with immune dysregulation, suggesting the interplay between the immune system and disease development. An altered immune environment leads to an exaggerated inflammatory response with the activation of innate immunity, involving the participation of mast cells, γδ T cells, and the NOD–LRR–pyrin-domain-containing protein 3 (NLRP3) inflammasome. […] This review aims to assess the complex relationship between Malassezia and the immune system in the pathogenesis of SD. We will explore how an impaired immune response predisposes the skin to Malassezia overgrowth and infection. We will examine the role of adaptive immunity, particularly T helper cells, in driving chronic inflammation in SD. All actors involved, whether part of innate or adaptive immunity, are responsible for the release of pro-inflammatory cytokines, which contribute to the progression of the disease.

• #14

  https://irispublishers.com/appr/fulltext/Seborrheic-Dermatitis-Exploring-the-Pathogenesis-Clinical-Features-And-Treatment-Strategies.ID.000571.php

  Malassezia species appear to contribute through inducing innate immunity in the skin via intricate interactions between fungal cells and virulence factors. This results in an increase in lipase synthesis, an inflammatory response by releasing oleic acid and arachidonic acid, and the creation of bioactive components from sebum lipids. Unsaturated fatty acids and metabolites released have direct irritating and scaling effects on keratinocytes, as well as inducing an enhanced inflammatory response due to epidermal barrier function loss. […] Concurrently, keratinocytes release proinflammatory cytokines such as IL-1, IL-6, IL-8, and TNF-, which augment and perpetuate the inflammatory response, therefore developing chronicity.

• #14

  https://irispublishers.com/appr/fulltext/Seborrheic-Dermatitis-Exploring-the-Pathogenesis-Clinical-Features-And-Treatment-Strategies.ID.000571.php

  Seborrheic dermatitis is a common chronic inflammatory skin condition that primarily affects sebum-rich areas such as the scalp, face, and trunk. […] The exact etiology of seborrheic dermatitis remains elusive, but a combination of genetic, environmental, and immunological factors is believed to play a role. Malassezia yeasts, particularly Malassezia spp, are thought to contribute to the development of the condition by triggering an abnormal immune response in susceptible individuals. […] The pathogenesis is influenced by a number of intrinsic and extrinsic factors, including sebaceous secretion, an increase in triglycerides and cholesterol and a decrease in squalene and free fatty acids, the colonization of Malassezia yeasts on the skins surface, host factor susceptibility, and interactions between these factors.

• #15 Seborrheic dermatitis associated with HIV infection: new concepts and hypotheses | Khryanin | HIV Infection and Immunosuppressive Disorders

  https://hiv.bmoc-spb.ru/jour/article/view/588?locale=en_US

  The most important role in pathogenesis of seborrheic dermatitis is belong to the fungus Malassazeia, which uses lipids from the skin surface to produce unsaturated and saturated fatty acids. These fatty acids, being left in the individuals skin, may induce an inflammatory response. […] However, it was reported about significant alterations in the lipid fractions of HIV-positive patients including a reduction in squalene and an increase in cholesterol and in cholesterol esters, which lead to hypercolonization of the skin with yeast-like fungi and their transition in the pathogenic micellar form.

• #16 Seborrheic Dermatitis: Causes, Symptoms, Treatment | National Eczema Association

  https://nationaleczema.org/eczema/types-of-eczema/seborrheic-dermatitis/

  Seborrheic dermatitis is a chronic, relapsing form of eczema that usually appears on the scalp but can occur anywhere there are a lot of oil-producing (sebaceous) glands like the chest, groin, beard region, and nose.1 Sebaceous glands are near hair follicles that secrete oil to lubricate hair and skin. Seborrheic dermatitis can cause a variety of symptoms from dandruff to a rash on the affected area.1 […] The exact cause of seborrheic dermatitis is unknown, but it is believed to be a combination of factors including genes, yeast that lives naturally on the skin, stress, chemical irritants and/or dry, cold weather that causes the skin to overproduce oil.1, 6 In infants, researchers believe seborrheic dermatitis is triggered in part by hormones from the mother.7 […] The trigger for seborrheic dermatitis is usually an inflammatory reaction to excess Malassezia yeast, also sometimes called pityrosporum, on the skin.1,6 This yeast, an organism that normally lives on the skins surface, is the likely cause of seborrheic dermatitis.1 The Malessezia overgrows and the immune system seems to overreact to it, leading to a fungal infection that results in skin changes.1 […] Seborrheic dermatitis is not an allergy.6 It is caused by genetic and environmental factors.6

• #17 Atopic dermatitis and seborrheic dermatitis | Pediatría integral

  https://www.pediatriaintegral.es/2021-english/atopic-dermatitis-and-seborrheic-dermatitis/

  Seborrheic dermatitis is a common eczema, with two clinical forms, the one found in the infant and that of the adult. The first is self-limited to the first 3 months of life; while, the second is chronic and, although it can present in puberty, its frequency is highest during the fourth to sixth decades of life. The latter affects men more than women. […] There is a relationship between seborrheic dermatitis and: overproduction of sebum (seborrhea), alterations in its composition and commensal yeasts of the genus Malassezia (Pityrosporum). […] The etiopathogenesis is not fully known, but there is a relationship with: overproduction of sebum (seborrhea), alterations in its composition and commensal yeasts of the genus Malassezia (Pityrosporum). In babies, sebum is produced for a few weeks after birth, and the adult form of SD does not develop before puberty, supporting a role of androgens in the activation of the sebaceous glands. However, patients with SD may have normal sebum production, and those with excessive sebum production usually do not have SD. Malassezia Furfur and other species can be isolated from SD lesions, including infant SD, but there is no relationship between the number of yeasts and the severity of SD (unaffected skin may have a microorganism load similar to that of lesions). Anyhow, with antifungal treatment, skin lesions improve and the number of yeasts decreases and, these increase again when SD relapses. It has also been discovered that a major component of the resident skin microflora, Propionibacterium acnes, is greatly diminished in SD; thus, it could be associated with an imbalance of the microbial flora.

• #18 Seborrhoeic dermatitis – Wikipedia

  https://en.wikipedia.org/wiki/Seborrhoeic_dermatitis

  Seborrhoeic dermatitis is a complex condition with many interacting factors that are not yet fully explained. In general, the major factors that influence the development and severity include Malassezia yeast present on and in the skin, skin production of oily sebum, and a subsequent inflammatory response against Malassezia and their byproducts. […] A suggested series of events leading to seborrhoeic dermatitis is an initially damaged skin barrier and abnormal sebum production, which leads to a change in the microbiome of the skin that in turn elicits an immune response. An alternative explanation is an increase in sebum production feeding an increase in the Malassezia population that instigates inflammation; the inflammation then causes cellular changes that damage the skin barrier. This barrier disruption then encourages additional Malassezia growth and inflammation and again worsens skin barrier function.

• #19 Seborrheic Dermatitis: Causes and Risk Factors

  https://www.verywellhealth.com/seborrheic-dermatitis-causes-4769875

  Despite the scientific evidence pointing towards a connection between seborrheic dermatitis and Malassezia, experts still debate about the strength of the link, and whether it’s a direct or indirect one. […] In the end, it’s possible that the link between Malassezia and seborrheic dermatitis may simply be an incidental finding. Regardless, the fact that seborrheic dermatitis responds to antifungal drugs, suggests some sort of connection. […] Interestingly, the connection between genetics and the development of seborrheic dermatitis is receiving more and more attention. […] In fact, scientists have found 11 gene mutations or protein deficiencies linked to seborrheic dermatitis. The majority of these genes or proteins play a role in the functioning of the immune system or how cells in the outer layer of the skin mature (called epidermal differentiation). […] By understanding how genes play a role in the development of seborrheic dermatitis, researchers can better target therapies to ultimately treat this benign, yet potentially burdensome, skin disease.

• #20 The pathogenesis of seborrheic dermatitis: a modern outlook – Immunopathology, allergology, infectology

  http://www.immunopathology.com/en/article.php?carticle=581

  Modern data reflect the complexity of cutaneous pathology in seborrheic dermatitis, a mosaic of various mechanisms and factors including gene expression, immune disregulation, changes in environment and host microbiome, as well as comorbidities. […] The data on epidemiology and etiopathogenesis of this skin disease are presented relative to the role of Malassezia spp. Various pathways of innate and adaptive immunity, induced by metabolites and pathogen-associated molecular patterns mediate the inflammation process and alteration of epidermal barrier observed in seborrheic dermatitis. […] There are certain gene mutations associated with seborrheic dermatitis. Recent studies enhance our understanding of seborrheic dermatitis as a complex multifactorial disease.

• #21 JMIR Dermatology – Nutrition, Obesity, and Seborrheic Dermatitis: Systematic Review

  https://derma.jmir.org/2024/1/e50143

  Increased serum iron, copper, and manganese cause oxidative stress by catalyzing the creation of reactive oxygen species, which in turn leads to the development of inflammatory skin diseases like atopic dermatitis and psoriasis. Systemic oxidative stress is also higher in patients with seborrheic dermatitis than in healthy subjects, suggesting a role in the pathogenesis of this disease. Thus, the findings of Jahan et al regarding elevated levels of serum iron, copper, and manganese in patients with seborrheic dermatitis may contribute to the cycle of oxidative stress, inflammation, and skin barrier disruption. […] Zinc is an essential trace element that assists in cell growth, development, and differentiation and plays catalytic and structural roles in transcription factors, receptors, growth factors, cytokines, and enzymes. It also possesses anti-inflammatory properties, including inhibiting polynuclear neutrophils chemotaxis and altering the production of interleukin-6 and tumor necrosis factor, 2 proinflammatory cytokines produced by keratinocytes. These inflammatory and androgenic pathways are essential to the pathogenesis of seborrheic dermatitis, therefore lower serum zinc levels in patients with seborrheic dermatitis may represent a precipitating factor to disease development.

• #21 JMIR Dermatology – Nutrition, Obesity, and Seborrheic Dermatitis: Systematic Review

  https://derma.jmir.org/2024/1/e50143

  Vitamin D plays a role in multiple skin processes, ranging from keratinocyte proliferation, differentiation, and apoptosis to immunoregulatory processes and barrier maintenance. Vitamin D enhances the synthesis of structural proteins and mediates immunosuppressive action in the skin. Thus, the lower 25-hydroxyvitamin D levels in patients with seborrheic dermatitis may decrease these protective functions, generating epidermal barrier dysfunction in seborrheic dermatitis.

• #22

  https://link.springer.com/article/10.1007/s13555-025-01351-z

  Seborrheic dermatitis (SD) is a common, chronic inflammatory skin condition affecting sebaceous gland-rich areas of the skin. The multifactorial etiology of SD involves sebocyte activity, skin microbiome dysbiosis, and immune factors. […] While the pathogenesis of SD remains unclear, its etiology is likely multifactorial, postulated to involve an interaction between sebocyte activity, dysbiosis of the skin microbiome with pathologic contributions from Malassezia yeast and Staphylococcus epidermidis overgrowth, genetic susceptibility, and an altered immune response. […] Predisposing factors such as immunosuppression, neurologic comorbid conditions, and stress can exacerbate symptoms.

• #23 Reddit – The heart of the internet

  https://www.reddit.com/r/SebDerm/comments/yvdnwg/academic_here_popping_in_to_share_some_new/

  For the past century, it is thought that Malassezia yeast colonization of the skin surface in lipid-rich areas leads to an inflammatory response due to the secretion of free-fatty-acids (FFA) and lipid peroxides on the skin. Your immune system generates selected cytokines (e.g., interleukins (IL): IL-1, IL-2, L-4, IL-8, IL-10, IL-12, TNC-alpha) that stimulates keratinocyte proliferation and differentiation. Soon, the skin barrier is disrupted and shows in visible forms like erythema, pruritus, and scaling. Of the 21 species of Malassezia, Malassezia restricta (M. restricta) and Malassezia globosa (M. globosa), M. arunalkei, M. sympodialis are associated with the majority of SDs. […] The type of Malassezia you get is different by geographic location and age, but all that is important here is that the agreed model of pathway for the development of SebDerm is (1) skin instability – (2) skin becomes less selective for microbial growth – (3) dysbiosis (worsens abnormal immune response) – (4) skin barrier disruption – (5) symptoms. The condition is chronic because steps 1, 2, 3 are cyclical. This means that if we don’t address the root cause, Malassezia will continue to colonize and recolonize areas with lipid-secretion (i.e., your sebaceous glands, which is most abundant on your face and scalp).

• #24

  https://europepmc.org/books/n/statpearls/article-28811/?extid=29262147&src=med

  Seborrheic dermatitis (SD) is a common inflammatory skin disease presenting with a papulosquamous morphology in areas rich in sebaceous glands, particularly the scalp, face, and body folds. […] There are multiple factors associated with the development of SD, and their disparate nature has led to many proposals about its cause and pathogenesis. The onset of SD appears linked to the interplay of normal microscopic skin flora (especially Malassezia spp.), the composition of lipids on the skin surface, and individual susceptibility. […] The proposed Mechanisms for the Pathogenesis of SD include: Disruption of the skins microbiota, An impaired immune reaction to Malassezia spp. associated with a diminished T-cell response and activation of complement, The increased presence of unsaturated fatty acids on the skin surface, Disruption of cutaneous neurotransmitters, Abnormal shedding of keratinocytes, Epidermal barrier disturbances associated with genetic factors.

• #25 Should Malassezia’s Role in Seborrheic Dermatitis Be Reconsidered?

  https://www.dermatologytimes.com/view/should-malassezia-s-role-in-seborrheic-dermatitis-be-reconsidered-

  The study authors concluded that more Malassezia may not cause the development of seborrheic dermatitis, and that instead, newer studies show that genetic factors that influence skin epidermal barrier and host immune activation may have a stronger contribution to the inflammation and skin disruption observed in SD than once thought.

• #25 Should Malassezia’s Role in Seborrheic Dermatitis Be Reconsidered?

  https://www.dermatologytimes.com/view/should-malassezia-s-role-in-seborrheic-dermatitis-be-reconsidered-

  Based on previous research, The most commonly proposed etiology of SD is based on this concept: Malassezia colonization on regions with high sebum secretion results in fatty acid production (secondary to yeast-driven sebum metabolism) that drives inflammation and disrupts the skin barrier in susceptible individuals, wrote Chang and Chovatiya. […] Newer research on the pathogenesis of seborrheic dermatitis now points to the influence of the cutaneous microbiome, according to the study authors. […] Chang and Chovatiya noted that inconsistencies across studies have made it difficult to credit Malassezia as the key factor in seborrheic dermatitis. […] According to Chang and Chovatiya, the inhibition of immune mediators and inflammatory cytokines with low-dose corticosteroids suggests that seborrheic dermatitis pathogenesis depends on inflammation and host immune response to drive clinical symptoms.

• #26

  https://www.healio.com/news/dermatology/20240529/yeast-and-zoryve-new-findings-provide-better-understanding-of-seborrheic-dermatitis

  The immune system and the skin barrier are important parts of this disease, Chovatiya said. And the yeast probably does have a part to play too, but it may not necessarily be causative. […] According to Chovatiya, the same way staphylococcus bacteria is an important and influential aspect, but not the primary cause, of atopic dermatitis, a similar relationship between Malassezia yeast and seborrheic dermatitis may be at play here. […] Seborrheic dermatitis has historically been somewhat of an afterthought because while it’s something that we commonly see in clinic, we never had pathogenesis-driven drug development that could allow us to both treat with high efficacy and appeal to diverse patient preferences for long-term management, he said. The fact that we can now specifically target an element of the inflammatory cascade to create a high level of response in a foam vehicle that allows all types of patients to use it on all parts of the body is really a win-win for everyone.

• #27 Modulating the skin mycobiome-bacteriome and treating seborrheic dermatitis with a probiotic-enriched oily suspension | Scientific Reports

  https://www.nature.com/articles/s41598-024-53016-0

  Seborrheic dermatitis (SD) affects 25% of the global population, with imbalances in the skin microbiome implicated in its development. […] The pathogenesis of SD is multifactorial, involving genetic predisposition, immune system dysregulation, and environmental factors. Moreover, the skin microbiome, particularly the complex interactions between commensal fungi and bacteria, is thought to play a crucial role in SD development and progression. […] Disruption of the skin microbiome, known as dysbiosis, has been implicated in various skin disorders, including SD, atopic dermatitis, acne, and psoriasis. […] Malassezia spp., a group of lipophilic yeasts, is considered the main fungi involved in SD pathogenesis, triggering an immune response that results in inflammation and scaling.

• #27 Modulating the skin mycobiome-bacteriome and treating seborrheic dermatitis with a probiotic-enriched oily suspension | Scientific Reports

  https://www.nature.com/articles/s41598-024-53016-0

  The relative abundances of Lactobacillus and Lacticaseibacillus, the two probiotic genera present in EUTOPLAC, increased substantially at T8. […] This was accompanied by a notable reduction in the genus Staphylococcus. […] The findings emphasize the potential of leveraging formulation ratios to optimize probiotic efficacy for skin health, warranting further investigation into the mechanisms driving these species-specific colonization trends.

• #28 Clinical study on treatment of facial seborrheic dermatitis with intense pulsed light combined with 30% supramolecular salicylic acid | Clinics

  https://www.elsevier.es/en-revista-clinics-22-articulo-clinical-study-on-treatment-facial-S1807593222003623

  Seborrheic dermatitis is an inflammatory skin disease that occurs in the sebum spillage, usually characterized by erythema and greasy scale. The pathogenesis of the disease is unclear. Current studies have shown that seborrheic dermatitis is closely related to the excessive sebum, the excessive reproduction of Malassezia furfur and Staphylococcus epidermidis, and the destruction of the skin barrier function. The application of antifungal drugs and glucocorticoids could alleviate the symptoms; however, long-term application will produce telangiectasia, epidermal atrophy, glucocorticoid dependence, and other adverse reactions. […] Salicylic acid can dissolve oil plugs, inhibit the oil secreted by sebaceous gland cells, and inhibit the excessive proliferation of sebaceous gland cells which could act on the pathogenesis of seborrheic dermatitis. Salicylic acid has an inhibitory effect on Malassezia furfur and Staphylococcus epidermidis caused by seborrheic dermatitis.

• #28 Clinical study on treatment of facial seborrheic dermatitis with intense pulsed light combined with 30% supramolecular salicylic acid | Clinics

  https://www.elsevier.es/en-revista-clinics-22-articulo-clinical-study-on-treatment-facial-S1807593222003623

  After IPL irradiation on the dermis, type I and type III collagen in the dermis increased; the infiltration of dermal inflammatory cells subsided, and the epidermis thickened. The IPL could stimulate the defense function of the tissue leading to bacteriostasis. Some scholars believe that the photothermal therapy of IPL can activate porphyrin to release the oxygen ions of singlet (or free state); the monomorphic oxygen would kill the chaff Malassezia furfur and Staphylococcus epidermidis, thus limiting the growth of bacteria. […] In this study the patients with seborrheic dermatitis were accompanied by skin barrier damage, thus single salicylic acid or IPL were relatively mild, making the onset time of single treatment slow with symptoms only being controlled after a course of treatment. Salicylic acid combined with IPL therapy compensated for this deficiency resulting in a significant improvement with no increased risk of complications after a single treatment. It was speculated that it was related to the synergistic effect of the IPL and salicylic acid. IPL could make up for the lack of shallow penetration depth of the salicylic acid, while salicylic acid could enhance the anti-inflammatory and oil-control effect of the IPL, thus contributing to the rapid and safe control of symptoms.

• #29 Is cutaneous microbiota a player in disease pathogenesis? Comparison of cutaneous microbiota in psoriasis and seborrheic dermatitis with scalp involvement – Indian Journal of Dermatology, Venereology and Leprology

  https://ijdvl.com/is-cutaneous-microbiota-a-player-in-disease-pathogenesis-comparison-of-cutaneous-microbiota-in-psoriasis-and-seborrheic-dermatitis-with-scalp-involvement/

  Evaluated together, the analyses indicate the presence of greater diversity in the scalp microbiota in both psoriasis vulgaris and seborrheic dermatitis compared to healthy skin, suggesting the loss of mechanisms against foreign invaders. […] The bacterial similarities between psoriasis vulgaris and seborrheic dermatitis suggest that these differences are a result rather than a cause of the respective diseases, and the lack of significant differences between the lesional and non-lesional psoriasis vulgaris samples, unlike in seborrheic dermatitis patients, indicates that psoriasis vulgaris is more severe than seborrheic dermatitis.

• #30 Differential microRNA profiles in elderly males with seborrheic dermatitis | Scientific Reports

  https://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. […] This study aimed to identify differentially expressed miRNAs (DEMs) in lesions of elderly male patients with SD. […] Functions of the SD-related miRNAs were predicted to be significantly associated with typical dermatological pathogenesis, such as cell proliferation, cell cycle, apoptosis, and immune regulation. […] In summary, SD alters the miRNA profile, and target mRNAs of the DEMs are related to immune responses and cell proliferation, which are the two main processes in SD pathogenesis. […] Several studies have been performed to determine the etiology of SD, with most studies focusing on the role of Malassezia in the disease pathogenesis.

• #30 Differential microRNA profiles in elderly males with seborrheic dermatitis | Scientific Reports

  https://www.nature.com/articles/s41598-022-24383-3

  Functional enrichment analysis of the DEMs was conducted using the Kyoto Encyclopedia of Genes and Genomes (KEGG), WikiPathways (WP), and REACTOME. […] Thus, the mRNA targetome of the DEMs in SD reflects gene expression regulation related to immune responses and cell proliferation, which are two main processes in SD pathogenesis. […] Therefore, our DEM data provide valuable insight into the molecular and cellular mechanisms underlying SD pathogenesis concerning the role of small non-coding RNA such as miRNA, which has not been previously explored in relation to this skin disease.

• #31 FDA Approves Arcutis’ ZORYVE® (roflumilast) Topical Foam, 0.3% for the Treatment of Seborrheic Dermatitis in Individuals Aged 9 Years and Older – Arcutis Biotherapeutics

  https://www.arcutis.com/fda-approves-arcutis-zoryve-roflumilast-topical-foam-0-3-for-the-treatment-of-seborrheic-dermatitis-in-individuals-aged-9-years-and-older/

  ZORYVE is a once-daily steroid-free foam and the first drug approved for seborrheic dermatitis with a new mechanism of action in over two decades. […] While multiple factors contribute to seborrheic dermatitis, inflammation and skin barrier dysfunction play key roles. […] ZORYVE has been shown to effectively reduce the signs of inflammation, redness, and scaling in patients with seborrheic dermatitis, and with its unique formulation, ZORYVE foam effectively delivers the drug without disrupting the skin barrier and has been shown to be safe and tolerable.

• #32 PRIME® Online Activity – Exploring Novel Topical Treatments for Atopic Dermatitis and Seborrheic Dermatitis

  https://primeinc.org/online/exploring-novel-topical-treatments-atopic-dermatitis-seborrheic-dermatitis

  Topical therapies with new mechanisms of action have recently emerged for the treatment of atopic dermatitis (AD) and seborrheic dermatitis (SD). These novel medications target specific molecules involved in disease pathogenesis, which can result in higher efficacy and fewer side effects than broad immunosuppressants. […] Assess the mechanisms of action of novel nonsteroidal topical therapies for atopic dermatitis and seborrheic dermatitis. […] Evaluate the efficacy and safety of new and emerging topical therapies for atopic dermatitis and seborrheic dermatitis.

• #33 Treating Seborrheic Dermatitis: Review of Mechanisms and Therapeutic Options – JDDonline – Journal of Drugs in Dermatology

  https://jddonline.com/articles/treating-seborrheic-dermatitis-review-of-mechanisms-and-therapeutic-options-S1545961613P0796X

  In that regard, an agent that provided the benefits of without the known consequences of steroids would be a better long-term option. […] The question to ask is: Can the anti-fungal activity against the mycelia forms of M. furfur (in the yeast phase known as Pityrosporum ovale) be enough to slow down or minimize the inflammatory process? […] Is comparison of steroid monotherapy to another agent that could be incorporated as both therapy and maintenance enough to change the approach to management? […] The non-steroidal alternatives have been considered by many to be viable options to steroids in the treatment of seborrheic dermatitis.

• #34 Seborrheic Dermatitis: New Formulations for Treatment

  https://www.skintherapyletter.com/family-practice/seborrheic-dermatitis-new-treatments-fp/

  Seborrheic dermatitis is a common cutaneous disorder occurring in at least 3%–5% of the population. […] While the detailed pathophysiology of seborrheic dermatitis remains to be clarified, the following are involved: Malassezia (formerly called Pityrosporum) yeasts, Sebum, Hereditary propensity. […] Sebum is necessary to support the growth of Malassezia. Although Malassezia yeasts are common colonizers of most adult scalps, only some individuals develop the flaking and inflammatory response of seborrheic dermatitis. The exact mechanism by which Malassezia yeasts induce inflammation is not fully understood. Lipases created by the organism produce free fatty acids such as oleic acid from sebum. Experimentally, application of oleic acid to scalps of susceptible individuals can mimic the scaling and erythema of seborrheic dermatitis. Other proposed mechanisms of inflammation initiation are alternative complement activation and Toll-like Receptor (TLR) stimulation by Malassezia.

• #35 Seborrhoeic Dermatitis – North & East

  https://northeast.devonformularyguidance.nhs.uk/referral-guidance/eastern-locality/dermatology/seborrhoeic-dermatitis

  Yeasts play an important role in the development of seborrhoeic dermatitis but the exact mechanism is not known. Control of the yeasts improves symptoms. […] Although the causes of seborrhoeic eczema are not fully understood, the yeast Malassezia ovale (M. ovale), formerly known as Pityrosporum ovale, is known to play a role. […] It is unclear as to how M. ovale induces inflammation and scaling, although there is a hypothesis that the yeast hydrolyzes sebum to release a mixture of saturated and unsaturated fatty acids. The fatty acids are taken up by the yeast but the unsaturated fatty acids remain and breach the skin’s barrier function causing the inflammatory reaction.

• #36 Seborrheic dermatitis – pathogenesis, epidemiology and effective treatment – literature review

  https://zenodo.org/record/8405267

  Seborrheic dermatitis (SD) is common inflammatory dermatology disease. Its affect up to 3-8% of the population. SD is characterized by erythema yellowish plaques and different level of itching and scaling. The last two symptoms are important factors that affect the quality of life of patients. This condition is usually a reaction to growth of Malassezia spp and commonly develop in regions of strong sebaceous glands such as the scalp, facial area, chest, back. Other factors include increased activity of sebaceous glands, immunosuppression, and stress. […] 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. Patients should be informed that ongoing maintenance treatment will be required. Treatment include topical antifungal (ketoconazole, Ciclopirox olamine, zinc pyrithione) and topical anti-inflammatory drugs like mild or mid-strength corticosteroids or calcineurin inhibitors (off-label use). In severe or resistance cases systematic therapy could be necessary. In this situation antifungal drugs (terbinafine, itraconazole) or low dose of isotretinoin are available options. Also new synergic treatments were introduce like cannabinoids or vitamin D which could make therapy more efficiency.

• #37 Medical treatment of atopic and seborrheic dermatitis – Abroad

  https://www.gsdinternational.com/treatments/medical-treatment-of-atopic-and-seborrheic-dermatitis

  The therapy of seborrheic dermatitis is carried out with galenic preparations based on sulfur, topical antifungals and also corticosteroids, but only for short periods. […] In seborrheic dermatitis systemic therapies are almost always contraindicated, since the pathogenesis is not allergic but psychosomatic and therefore prone to relapse. Local therapies such as anti-inflammatory non-cortisone emollients or galenic products containing sulfur and local antimicrobials are preferred.

• #38 Seborrheic Dermatitis | 5-Minute Emergency Consult

  https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307189/all/Seborrheic_Dermatitis

  A common and chronic papulosquamous inflammatory skin disorder. […] Exact pathogenesis not fully understood. […] Multifactorial with environmental, genetic, hormonal, immunologic, microbial, and nutritional influences. […] Strong association with Malassezia yeasts. […] Complex physiologic response: Immunologic, Inflammatory, Hyperproliferation. […] Disease flares are common with physical and emotional stress or illness.

• #39 What Is Seborrheic Dermatitis? – Consensus: AI Search Engine for Research

  https://consensus.app/home/blog/what-is-seborrheic-dermatitis/

  Seborrheic dermatitis (SD) is a chronic inflammatory skin disorder that primarily affects areas of the skin rich in sebaceous glands, such as the scalp and face. […] The exact cause of seborrheic dermatitis is not fully understood, but it is believed to be associated with the yeast Malassezia, which is commonly found on the skin. This yeast is thought to play a key role in the pathogenesis of the disease by triggering an inflammatory response. Additionally, factors such as increased skin oiliness and barrier dysfunction are also implicated in the development of SD. […] Seborrheic dermatitis is a prevalent and recurrent skin condition with a complex pathogenesis involving yeast colonization and inflammatory responses.

• #40 Seborrheic dermatitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/seborrheic-dermatitis/symptoms-causes/syc-20352710

  Seborrheic dermatitis may go away without treatment. Or you may need to use medicated shampoo or other products long term to clear up symptoms and prevent flare-ups. […] The exact cause of seborrheic dermatitis isn’t clear. It may be due to the yeast Malassezia, excess oil in the skin or a problem in the immune system.

• #41 Navigating Seborrheic Dermatitis (SD): An Overview With Expert Perspectives

  https://www.hcplive.com/view/navigating-seborrheic-dermatitis-sd-an-overview-with-expert-perspectives

  Seborrheic dermatitis is an inflammatory skin disease, and it’s characterized by these arthmetis, so red, scaly patches and plaques that you have on areas where you have an increased number of sebaceous glands. […] In terms of pathogenesis, I like to think of a few key things. There seems to be a role for malassezia, so a fungal constituent on our skin. We know that the sebum or sebaceous glands are very important because of those geographical regions that are affected. Finally, we also know that there’s inflammation, and we know that there are certain cytokines that are involved as well.

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