Advertisement

Seborrheic Dermatitis

  • Juliano de Avelar Breunig
  • Marco Otavio Rocha Couto
Chapter

Abstract

Seborrheic dermatitis is a very prevalent inflammatory skin disorder. The affected skin presents as erythematous, edematous, and covered with scales (or even crusts) which are yellowish, erythematous, or brown. There are many associated factors whose recognition is important. A variety of available treatment modalities is discussed in this chapter.

Keywords

Seborrheic dermatitis Dermatitis Colonization Scaling Fungi Inflammation Sebum Erythema Malassezia Immunodeficiencies Stress 

Notes

Glossary

Calcineurin inhibitor

Calcineurin (CaN) is a calcium- and calmodulin-dependent serine/threonine protein phosphatase. Calcineurin inhibitors suppress the immune system by preventing interleukin-2 (IL-2) production in T cells.

Chemotaxis

A mechanism by which bacteria efficiently and rapidly respond to changes in the chemical composition of their environment, approaching chemically favorable environments and avoiding unfavorable ones.

Human leukocyte antigen (HLA)

The major histocompatibility complex (MHC) in humans, controlled by genes located on chromosome 6. It encodes cell surface molecules specialized to present antigenic peptides to the T-cell receptor (TCR) on T cells.

Psoralen

The parent compound in a family of natural products known as furocoumarins. Psoralen is a light-sensitive drug that absorbs ultraviolet (long wave, UVA) light and acts like ultraviolet radiation.

References

  1. 1.
    Schwartz RA, Janusz CA, Janniger CK. Seborrheic dermatitis: an overview. Am Fam Physician. 2006;74(1):125–30.PubMedGoogle Scholar
  2. 2.
    Warner RR, et al. Dandruff has an altered stratum corneum ultrastructure that is improved with zinc pyrithione shampoo. J Am Acad Dermatol. 2001;45(6):897–903.PubMedCrossRefGoogle Scholar
  3. 3.
    Berkt T, Scheinfeld N. Seborrheic dermatitis. P T. 2010;35(6):348–52.Google Scholar
  4. 4.
    Szepietowski JC, et al. Quality of life in patients suffering from seborrheic dermatitis: influence of age, gender and education level. Mycoses. 2009;52(4):357–63.PubMedCrossRefGoogle Scholar
  5. 5.
    Kligman AM, Mcginley KJ, Leyden JJ. The nature of dandruff. J Soc Cosmet Chem. 1976;27:111–39.Google Scholar
  6. 6.
    Lynch PJ. Dermatologic problems of the head and neck in the aged. Otolaryngol Clin N Am. 1982;15(2):271–85.Google Scholar
  7. 7.
    Johnson ML, Johnson KG, ENGEL A. Prevalence, morbidity, and cost of dermatologic diseases. J Am Acad Dermatol. 1984;11(5):930–6.PubMedCrossRefGoogle Scholar
  8. 8.
    Johnson MT, Roberts J. Skin conditions and related need for medical care among persons 1-74 years. United States, 1971-1974. Vital Health Stat. 1978;11:1–72.Google Scholar
  9. 9.
    Dawson TL. Malassezia globosa and restricta: breakthrough understanding of the etiology and treatment of dandruff and seborrheic dermatitis through whole-genome analysis. J Investig Dermatol Symp Proc. 2007;12(2):15–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Dogliotti M. Skin disorders in the Bantu: a survey of 2.000 cases from Baragwanath Hospital. S Afr Med J. 1970;44(23):670–2.PubMedGoogle Scholar
  11. 11.
    Mahe A, et al. Predictive value of seborrheic dermatitis and other common dermatoses for HIV infection in Bamako, Mali. J Am Acad Dermatol. 1996;34(6):1084–6.PubMedCrossRefGoogle Scholar
  12. 12.
    Olumide YM, Odunowo BD, Odiase AO. Depigmentation in black African patients. Int J Dermatol. 1990;29(3):166–74.PubMedCrossRefGoogle Scholar
  13. 13.
    Dunic I, Vesic S, Jevtovic DJ. Oral candidiasis and seborrheic dermatitis in HIV-infected patients on highly active antiretroviral therapy. HIV Med. 2004;5(1):50–4.PubMedCrossRefGoogle Scholar
  14. 14.
    Farthing CF, Staughton RCD, Rowland A, Payne CME. Skin disease in homosexual patients with acquired immune deficiency syndrome (AIDS) and lesser forms of human T cell leukaemia virus (HTLV III) disease. Clin Exp Dermatol. 1985;10(1):3–12.PubMedCrossRefGoogle Scholar
  15. 15.
    Smith KJ, et al. Cutaneous findings in HIV-1 positive patients: a 42-month prospective study. J Am Acad Dermatol. 1994;31(5):746–54.PubMedCrossRefGoogle Scholar
  16. 16.
    Burton JL, Pye RJ. Seborrhoea is not a feature of seborrhoeic dermatitis. Br Med J. 1983;286(6372):1169–70.CrossRefGoogle Scholar
  17. 17.
    Pilgram GS, et al. The influence of two azones and sebaceous lipids on the lateral organization of lipids isolated from human stratum corneum. Biochim Biophys Acta. 2001;1511(2):244–54.PubMedCrossRefGoogle Scholar
  18. 18.
    Theile JJ, Weber SU, Packer L. Sebaceous gland activity is a major physiologic route of vitamin E delivery to the skin. J Invest Dermatol. 1999;113(6):1006–10.CrossRefGoogle Scholar
  19. 19.
    Thiboutot D, et al. Human skin is a steroidogenic tissue: steroidogenic enzymes and cofactors are expressed in epidermis, normal sebocytes, and an immortalized sebocyte cell line (SEB-1). J Invest Dermatol. 2003;120(6):905–14.PubMedCrossRefGoogle Scholar
  20. 20.
    Zouboulis CC. Sebaceous gland in human skin—the fantastic future of a skin appendage. J Invest Dermatol. 2003;120(6):14–5.CrossRefGoogle Scholar
  21. 21.
    Bergbrant IM. Seborrhoeic dermatitis and Pityrosporum ovale: cultural, immunological and clinical studies. Acta Derm Venereol Suppl (Stockh). 1991;167:1–36.Google Scholar
  22. 22.
    Shi VY, Leo M, Hassoun L, Chahal DS, Maibach HI, Sivamani RK. Role of sebaceous glands in inflammatory dermatoses. J Am Acad Dermatol. 2015;73(5):856–63.PubMedCrossRefGoogle Scholar
  23. 23.
    Kim SY, Kim SH, Kim SN, Kim AR, Kim YR, Kim MJ, Park WS, Lee JH, Jung WH, Lee YW, Choe YB, Ahn KJ. Isolation and identification of Malassezia species from Chinese and Korean patients with seborrheic dermatitis and in vitro studies on their bioactivity on sebaceous lipids and IL-8 production. Mycoses. 2016;59(5):274–80.PubMedCrossRefGoogle Scholar
  24. 24.
    Geissler SE, Michelsen S, Plewig G. Very low dose isotretinoin is effective in controlling seborrhea. J Dtsch Dermatol Ges. 2003;1(12):952–8.PubMedCrossRefGoogle Scholar
  25. 25.
    Gupta AK, Madzia SE, Batra R. Etiology and management of seborrheic dermatitis. Dermatology. 2004;208(2):89–93.PubMedCrossRefGoogle Scholar
  26. 26.
    Harding CR, et al. Dandruff: a condition characterized by decreased levels of intercellular lipids in scalp stratum corneum and impaired barrier function. Arch Dermatol Res. 2002;294(5):221–30.PubMedCrossRefGoogle Scholar
  27. 27.
    Bettley FR, Marten RH. Unilateral seborrhoeic dermatitis following a nerve lesion. Arch Dermatol. 1956;73(2):110–5.CrossRefGoogle Scholar
  28. 28.
    Wilson CL, Walshe M. Incidence of seborrhoeic dermatitis in spinal injury patients. Br J Dermatol. 1988;119(33):48–8.Google Scholar
  29. 29.
    Tajima M, et al. Molecular analysis of Malassezia microflora in seborrheic dermatitis patients: comparison with other diseases and healthy subjects. J Invest Dermatol. 2008;128(2):345–51.PubMedCrossRefGoogle Scholar
  30. 30.
    Batra R, et al. Malassezia Baillon, emerging clinical yeasts. FEMS Yeast Res. 2005;5(11):1101–13.PubMedCrossRefGoogle Scholar
  31. 31.
    Ro BI, Dawson TL. The role of sebaceous gland activity and scalp microfloral metabolism in the etiology of seborrheic dermatitis and dandruff. J Investig Dermatol Symp Proc. 2005;10(3):194–7.PubMedCrossRefGoogle Scholar
  32. 32.
    Rosenberg EW. Effect of topical applications of heavy suspensions of killed Malassezia ovalis on rabbit skin. Mycopathologia. 1980;72(3):147–52.PubMedCrossRefGoogle Scholar
  33. 33.
    Faergemann J, et al. Seborrhoeic dermatitis and Pityrosporum (Malassezia) folliculitis: characterization of inflammatory cells and mediators in the skin by immunohistochemistry. Br J Dermatol. 2001;144(3):549–56.PubMedCrossRefGoogle Scholar
  34. 34.
    Deangelis YM, et al. Isolation and expression of a Malassezia globosa lipase gene, LIP1. J Invest Dermatol. 2007;127(9):2138–46.PubMedCrossRefGoogle Scholar
  35. 35.
    Dietrich FS, et al. The Ashbya gossypii genome as a tool for mapping the ancient Saccharomyces cerevisiae genome. Science. 2004;304(5668):304–7.PubMedCrossRefGoogle Scholar
  36. 36.
    Hermida L, et al. The Ashbya genome database (AGD) – a tool for the yeast community and genome biologists. Nucleic Acids Res. 2005;33(1):348–52.Google Scholar
  37. 37.
    Chen TA, Hill PB. The biology of Malassezia organisms and their ability to induce immune responses and skin disease. Vet Dermatol. 2005;16(1):4–26.PubMedCrossRefGoogle Scholar
  38. 38.
    Thomas DS, et al. In vitro modulation of human keratinocyte pro- and anti- inflammatory cytokine production by the capsule of Malassezia species. FEMS Immunol Med Microbiol. 2008;54(2):203–14.PubMedCrossRefGoogle Scholar
  39. 39.
    Xu J, et al. Dandruff-associated Malassezia genomes reveal convergent and divergent virulence traits shared with plant and human fungal pathogens. Proc Natl Acad Sci U S A. 2007;104(47):18730–5.PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
    Rendic E, Diaz C, Fich F. Characterization of species of the gender Malassezia in patients with seborrheic dermatitis and subjects without skin lesions. Rev Med Chil. 2003;131(11):1295–300.PubMedCrossRefGoogle Scholar
  41. 41.
    Baroni A, et al. New strategies in dandruff treatment: growth control of Malassezia ovalis. Dermatology. 2000;201(4):332–6.PubMedCrossRefGoogle Scholar
  42. 42.
    Cohen S. Should we treat infantile seborrhoeic dermatitis with topical antifungals or topical steroids. Arch Dis Child. 2004;89(3):288–9.PubMedPubMedCentralCrossRefGoogle Scholar
  43. 43.
    Pierard GE, et al. Prolonged effects of antidandruff shampoos – time to recurrence of Malassezia ovalis colonization of skin. Int J Cosmet Sci. 1997;19(2):111–7.PubMedCrossRefGoogle Scholar
  44. 44.
    Erchiga VC, Florencio VD. Malassezia species in skin diseases. Curr Opin Infect Dis. 2002;15(2):133–42.CrossRefGoogle Scholar
  45. 45.
    Pierard GE, Xhauflaires-Uhoda E, Pierard-Franchimont C. The key role of corneocytes in pityrosporoses. Dermatology. 2006;212(1):23–6.PubMedCrossRefGoogle Scholar
  46. 46.
    Pierard-Franchimont C, et al. A multicenter randomized trial of ketoconazole 2% and zinc pyrithione 1% shampoos in severe dandruff and seborrheic dermatitis. Skin Pharmacol Appl Ski Physiol. 2001;15(6):434–41.CrossRefGoogle Scholar
  47. 47.
    Deangelis YM, et al. Three etiologic facets of dandruff and seborrheic dermatitis: Malassezia fungi, sebaceous lipids, and individual sensitivity. J Investig Dermatol Symp Proc. 2005;10(3):295–7.PubMedCrossRefGoogle Scholar
  48. 48.
    Parry ME, Sharpe GR. Seborrhoeic dermatitis is not caused by an altered immune response to Malassezia yeast. Br J Dermatol. 1998;139(2):254–63.PubMedCrossRefGoogle Scholar
  49. 49.
    Wikler JR, Nieboer C, Willmenze R. Quantitative skin cultures of Pityrosporum yeasts in patients seropositive for the human immunodeficiency virus with and without seborrheic dermatitis. J Am Acad Dermatol. 1992;27(1):37–9.PubMedCrossRefGoogle Scholar
  50. 50.
    Prohic A, Kasumagic-Halilovic E. Identification of Malassezia species from immunocompetent and immunocompromised patients with seborrheic dermatitis. Eur Rev Med Pharmacol Sci. 1999;14(12):1019–23.Google Scholar
  51. 51.
    Kahlke B, Brasch J, Christophers E. Dermatophytes contain a novel lipid like leukocyte activator. J Invest Dermatol. 1996;107(1):108–12.PubMedCrossRefGoogle Scholar
  52. 52.
    Mayser P, et al. Differentiation of Malassezia species: selectivity of Cremophor EL, castor oil and ricinoleic acid for M. furfur. Br J Dermatol. 1997;137(2):208–13.PubMedCrossRefGoogle Scholar
  53. 53.
    Sampaio AL, Porto LC, Silva MR, Nunes AP, Oliveira JC, Silva GMF, Mameri A, Cassia FF, Carneiro SC. Human leucocyte antigen frequency in a miscegenated population presenting with seborrhoeic dermatitis. J Eur Acad Dermatol Venereol. 2014;28(11):1576–7.PubMedCrossRefGoogle Scholar
  54. 54.
    Gupta AK, Bluhm R, Cooper EA, Summerbell RC, Batra R. Seborrheic dermatitis. Dermatol Clin. 2003;21:401–12.PubMedCrossRefGoogle Scholar
  55. 55.
    Breunig JA, et al. Scalp seborrheic dermatitis: prevalence and associated factors in male adolescents. Int J Dermatol. 2012;51(1):46–9.CrossRefGoogle Scholar
  56. 56.
    Breunig JA. Dermatite seborreica em adolescentes masculinos de 18 anos: prevalência e fatores associados em um estudo de base populacional. PhD thesis. PUCRS – Biblioteca Digital de Teses e Dissertações. Avaiable from: http://tede2.pucrs.br/tede2/handle/tede/1618; 2016.
  57. 57.
    Dowlati B, et al. Insulin quantification in patients with seborrheic dermatitis. Arch Dermatol. 1998;134(8):1043–5.PubMedCrossRefGoogle Scholar
  58. 58.
    Garcia HL. Dermatological complications of obesity. Am J Clin Dermatol. 2002;3(7):497–506.CrossRefGoogle Scholar
  59. 59.
    Ruiz Perez L, et al. Lipid profile and hormonal study in the school children of the province of Alicante. Endocrinol Nutr. 2009;56(4):158–63.PubMedCrossRefGoogle Scholar
  60. 60.
    Lello S, et al. Effects of two estroprogestins containing ethynilestradiol 30 microg and drospirenone 3 mg and ethynilestradiol 30 microg and chlormadinone 2 mg on skin and hormonal hyperandrogenic manifestations. Gynecol Endocrinol. 2008;24(12):718–23.PubMedCrossRefGoogle Scholar
  61. 61.
    Raubrant D, Rabe T. Progestogens with antiandrogenic properties. Drugs. 2003;63(5):463–92.CrossRefGoogle Scholar
  62. 62.
    Walker J, Adams B. Cutaneous manifestations of anabolic-androgenic steroid use in athletes. Int J Dermatol. 2009;48(10):1044–8.PubMedCrossRefGoogle Scholar
  63. 63.
    Bourne S, Jabobs A. Observations on acne, seborrhoea, and obesity. Br Med J. 1956;1(4978):1268–70.PubMedPubMedCentralCrossRefGoogle Scholar
  64. 64.
    Linder D, Dreiher J, Zampetti A, Sampogna F, Cohen AD. Seborrheic dermatitis and hypertension in adults: a cross-sectional study. J Eur Acad Dermatol Venereol. 2014;28(11):1450–5.PubMedCrossRefGoogle Scholar
  65. 65.
    Misery L, et al. Stress and seborrheic dermatitis. Ann Dermatol Venereol. 2007;134(11):833–7.PubMedCrossRefGoogle Scholar
  66. 66.
    Berg M. Epidemiological studies of the influence of sunlight on the skin. Photo-Dermatology. 1989;6(2):80–4.PubMedGoogle Scholar
  67. 67.
    Tegner E. Seborrhoeic dermatitis of the face induced by PUVA treatment. Acta Derm Venereol. 1983;63(4):335–9.PubMedGoogle Scholar
  68. 68.
    Moehrle M, et al. High prevalence of seborrhoeic dermatitis on the face and scalp in mountain guides. Dermatology. 2000;201(2):146–7.PubMedCrossRefGoogle Scholar
  69. 69.
    Yeung CK, Chan HH. Cutaneous adverse effects of lithium: epidemiology and management. Am J Clin Dermatol. 2004;5(1):3–8.PubMedCrossRefGoogle Scholar
  70. 70.
    Scheinfeld NS. Seborrheic dermatitis. Skinmed. 2005;4(1):49–50.PubMedCrossRefGoogle Scholar
  71. 71.
    Pierard GE. Seborrheic dermatitis today, gone tomorrow? The link between the biocene and treatment. Dermatology. 2003;206(3):187–8.PubMedCrossRefGoogle Scholar
  72. 72.
    Arsenijevic VSA, Milobratovic D, Barac AM, Vekic B, Marinkovic J, Kostic VS. A laboratory-based study on patients with Parkinson’s disease and seborrheic dermatitis: the presence and density of Malassezia yeasts, their different species and enzymes production. BMC Dermatol. 2014;14:5.CrossRefGoogle Scholar
  73. 73.
    Appenzeller O, Harville D. Effect of L-dopa on seborrhea of Parkinsonism. Lancet. 1970;2(7667):311–2.PubMedGoogle Scholar
  74. 74.
    Marco-Llorente J, Rojo-Martinez E. Other non-motor disorders in Parkinson’s disease. Rev Neurol. 2010;50(2):75–83.Google Scholar
  75. 75.
    Mallal SA. The Western Australian HIV Cohort Study, Perth, Australia. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;17(1):23–7.CrossRefGoogle Scholar
  76. 76.
    Bonamigo RR, et al. Human T lymphotropic virus 1 and hepatitis virus as risk factors for inflammatory dermatoses in HIV-positive patients. Int J Dermatol. 2004;43(8):568–70.PubMedCrossRefGoogle Scholar
  77. 77.
    Bittencourt AL, Oliveira MF. Cutaneous manifestations associated with HTLV-1 infection. Int J Dermatol. 2010;49(10):1099–110.PubMedCrossRefGoogle Scholar
  78. 78.
    Ercis M, Balci S, Atakan N. Dermatological manifestations of 71 Down syndrome children admitted to a clinical genetics unit. Clin Genet. 1996;50(5):317–20.PubMedGoogle Scholar
  79. 79.
    Rocha N, et al. Cutaneous manifestations of familial amyloidotic polyneuropathy. J Eur Acad Dermatol Venereol. 2005;19(5):605–7.PubMedCrossRefGoogle Scholar
  80. 80.
    Seite S, et al. A lipohydroxyacid-containing shampoo improves scalp condition and quality of life in patients with seborrheic dermatitis and light-to-moderate scalp psoriasis. J Cosmet Dermatol. 2009;8(2):108–13.PubMedCrossRefGoogle Scholar
  81. 81.
    Foley P, et al. The frequency of common skin conditions in preschool-aged children in Australia: seborrheic dermatitis and pityriasis capitis (cradle cap). Arch Dermatol. 2003;139(3):318–22.PubMedCrossRefGoogle Scholar
  82. 82.
    Shuster S. The aetiology of dandruff and the mode of action of therapeutic agents. Br J Dermatol. 1984;111(2):235–42.PubMedCrossRefGoogle Scholar
  83. 83.
    Erlichman M, et al. Infantile flexural seborrhoeic dermatitis. Neither biotin nor essential fatty acid deficiency. Arch Dis Child. 1981;56(7):560–2.PubMedPubMedCentralCrossRefGoogle Scholar
  84. 84.
    Xu C, Chen D, Liu J, Liu Y, Sun Q. Roles of dermoscopy in the diagnosis and differential diagnosis of scalp psoriasis and seborrheic dermatitis. Zhonghua Yi Xue Za Zhi. 2014;94(44):3467–70.PubMedGoogle Scholar
  85. 85.
    Sampaio AL, Mameri AC, Vargas TJ, Silva MR, Nunes AP, Carneiro SC. Seborrheic dermatitis. An Bras Dermatol. 2011;86(6):1061–74.PubMedCrossRefGoogle Scholar
  86. 86.
    Agozzino M, Berardesca E, Donadio C, Franceschini C, Felice CM, Cavallotti C, Sperduti I, Ardigò M. Reflectance confocal microscopy features of seborrheic dermatitis for plaque psoriasis differentiation. Dermatology. 2014;229(3):215–21.PubMedCrossRefGoogle Scholar
  87. 87.
    Naldi L, Rebora A. Clinical practice. Seborrheic dermatitis. N Engl J Med. 2009;360(4):387–96.PubMedCrossRefGoogle Scholar
  88. 88.
    Faergemann J, Fredriksson T. The antimycotic activity in vitro of five diols. Sabouraudia. 1980;18(4):287–93.PubMedCrossRefGoogle Scholar
  89. 89.
    Bhatia N. Treating seborrheic dermatitis: review of mechanisms and therapeutic options. J Drugs Dermatol. 2013;12(7):796–8.PubMedGoogle Scholar
  90. 90.
    Okokon EO, Verbeek JH, Ruotsalainen JH, Ojo OA, Bakhoya VN. Topical antifungals for seborrhoeic dermatitis. Cochrane Database Syst Rev. 2015;(5):CD008138.Google Scholar
  91. 91.
    Langtry JA, et al. Topical lithium succinate ointment (Efalith) in the treatment of AIDS-related seborrhoeic dermatitis. Clin Exp Dermatol. 1997;22(5):216–9.PubMedCrossRefGoogle Scholar
  92. 92.
    Peter RU, Richarz-Barthauer U. Successful treatment and prophylaxis of scalp seborrhoeic dermatitis and dandruff with 2% ketoconazole shampoo: results of a multicentre, double-blind, placebo-controlled trial. Br J Dermatol. 1995;132(3):441–5.PubMedCrossRefGoogle Scholar
  93. 93.
    Danby FW, et al. A randomized, double-blind, placebo-controlled trial of ketoconazole 2% xampu versus selenium sulfide 2.5% xampu in the treatment of moderate to severe dandruff. J Am Acad Dermatol. 1993;29(6):1008–12.PubMedCrossRefGoogle Scholar
  94. 94.
    Seckin D, Gurbuz O, Akin O. Metronidazole 0.75% gel vs. Ketoconazole 2% cream in the treatment of facial seborrheic dermatitis: a randomized, double-blind study. J Eur Acad Dermatol Venereol. 2007;21(3):345–50.PubMedCrossRefGoogle Scholar
  95. 95.
    Marks R, Pearse AD, Walker AP. The effects of a shampoo containing zinc pyrithione on the control of dandruff. Br J Dermatol. 1985;112(4):415–22.PubMedCrossRefGoogle Scholar
  96. 96.
    Opdyke DL, Burnett CM, Brauer EW. Anti-seborrhoeic qualities of zinc pyrithione in a cream vehicle: II. Safety evaluation. Food Cosmet Toxicol. 1967;5(3):321–6.PubMedCrossRefGoogle Scholar
  97. 97.
    Kastarinen H, Okokon E O, Verbeek JH. Topical anti-inflammatory agents for seborrheic dermatitis of the face or scalp. Summary of a Cochrane Review. JAMA Dermatol Clin Evid Synop. 2015;151(2):221–2.CrossRefGoogle Scholar
  98. 98.
    Kim HO, Yang YS, Ko HC, Kim GM, Cho SH, Seo YJ, Son SW, Lee JR, Lee JS, Chang SE, Che JW, Park CW. Maintenance therapy of facial seborrheic dermatitis with 0.1% tacrolimus ointment. Ann Dermatol. 2015;27(5):523–30.PubMedPubMedCentralCrossRefGoogle Scholar
  99. 99.
    Kim TW, et al. Proactive treatment of adult facial seborrhoeic dermatitis with 0.1% tacrolimus ointment: randomized, double-blind, vehicle-controlled, multi-centre trial. Acta Derm Venereol. 2013;93:557–61.PubMedCrossRefGoogle Scholar
  100. 100.
    Ghodsi SZ, Abbas Z, Abedeni R. Efficacy of oral itraconazole in the treatment and relapse prevention of moderate to severe seborrheic dermatitis: a randomized, placebo-controlled trial. Am J Clin Dermatol. 2015;16(5):431–7.PubMedCrossRefGoogle Scholar
  101. 101.
    Alizadeh N, Monadi Nori H, Golchi J, Eshkevari SS, Kazemnejad E, Darjani A. Comparison the efficacy of fluconazole and terbinafine in patients with moderate to severe seborrheic dermatitis. Dermatol Res Pract. 2014;20(14):402–705.Google Scholar
  102. 102.
    Gupta AK, Richardson M, Paquet M. Systematic review of oral treatments for seborrheic dermatitis. J Eur Acad Dermatol Venereol. 2014;28(1):16–26.PubMedCrossRefGoogle Scholar
  103. 103.
    Abraham S, Piguet V. An unusual presentation of Malassezia dermatosis. Dermatology. 2016;212:4–6.CrossRefGoogle Scholar
  104. 104.
    Clark GW, Pope SM, Jaboori KA. Diagnosis and treatment of seborrheic dermatitis. Am Fam Physician. 2015;91(3):185–90.PubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2018

Authors and Affiliations

  • Juliano de Avelar Breunig
    • 1
  • Marco Otavio Rocha Couto
    • 2
  1. 1.Hospital Santa Cruz, UNISCSanta Cruz do SulBrazil
  2. 2.Hospital AnchietaBrasíliaBrazil

Personalised recommendations