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Seborrheic dermatitis (SD) is a highly prevalent dermatological condition globally. The condition demonstrates bimodal presentation with what is commonly thought to be two subtypes: adult/adolescent seborrheic dermatitis (ASD) and infantile seborrheic dermatitis (ISD). Despite the common prevalence of ASD and ISD, there remains uncertainty around the underlying pathogenetic mechanisms, risk factors, and appropriate classification of the disease(s). This narrative review summarizes the current understanding of the epidemiology, presentation, and pathogenetic factors like epidermal barrier dysfunction, lipid abnormalities, and cutaneous microbiome for ASD and ISD. Elements such as immune responsiveness, neuroendocrine factors, and genetics in these disease states are also investigated. Throughout our review, we highlight shared features and discrepancies between ASD and ISD that are present in the literature and discuss potential avenues for future research that explore these disease states. We aim to contribute to the medical discourse on ASD and ISD and increase awareness of the need for additional research around these conditions, ultimately informing better targeting of therapeutics moving forward., (© 2024 the International Society of Dermatology.)

Background: This paper examines alternative procedural interventions for Seborrheic Dermatitis (SD), aiming to offer clinicians more treatment options and encourage further research., Method: A search was conducted on PubMed using specific search terms related to SD and various dermatological procedures. Studies in English, focusing on SD in human patients, and in-office treatments were included. Data were analyzed for procedure type, effectiveness, and side effects., Results: Nine studies were reviewed, covering phototherapy, indole-3-acetic acid photodynamic therapy (IAA-PDT), Picosecond Nd:YAG laser, botulinum toxin (BoNT) injections, triamcinolone injections, hair growth factor therapy, and precision cryotherapy. Most showed significant efficacy in small cohorts with high patient satisfaction. Hair growth factor therapy had long-term benefits, while narrow-band ultraviolet B phototherapy showed relapse within one month. Intense pulsed light with supramolecular salicylic acid, IAA-PDT, and laser therapy reduced sebum output and Malassezia furfur. Triamcinolone injections were effective against SD's immunological aspects. Hair growth factor therapy and precision cryotherapy have been successfully used to treat scalp SD. The role of BoNT in SD is still being explored; however, current evidence does not support its use., Conclusion: Limited data reveal the need for further research on dermatological procedures for SD. These methods show promise for better patient compliance but face challenges such as cost, variable effectiveness, and unknown long-term safety. Future research should focus on protocol standardization and comprehensive evaluation of long-term outcomes. J Drugs Dermatol. 2024;23(10):819-824. doi:10.36849/JDD.8116.

Introduction: Seborrheic dermatitis (SD) poses significant treatment challenges due to its chronic nature and the side effects associated with long-term use of conventional therapies like topical corticosteroids. In the search for alternative treatments, exosomes, particularly those derived from rose stem cells (RSCEs), offer a promising avenue due to their potential in managing chronic skin conditions., Objective: This case report examines the efficacy of a topical moisturizer containing RSCEs in treating a patient with refractory SD, aiming to provide an alternative treatment pathway., Materials and Methods: A 40-year-old male with a long-standing history of SD, unresponsive to traditional treatments, underwent a novel treatment regimen. This regimen included an initial topical application of 2.5 mL of RSCEs followed by a maintenance phase involving the application of a RSCE-containing moisturizer. Clinical outcomes were assessed through the Patient's Global Assessment (PGA) and Investigator's Global Assessment (IGA) scores, along with evaluations of scaling and erythema., Results: Remarkable clinical improvement was noted as early as 1-day post-treatment, with significant reductions in redness, scaling, and itching. The patient experienced sustained relief throughout the 6-month follow-up, with a recurrence in the sixth month that was less severe than previous flare-ups. This demonstrated not only the efficacy of RSCEs in symptom management but also their potential in extending remission periods., Conclusion: The chronic management of SD can benefit from innovative treatments like the RSCE-containing moisturizer, as shown in this case report. While the observed outcomes are promising, indicating substantial improvements in skin condition and symptom management, larger controlled studies are necessary to validate the therapeutic potential of exosome-containing moisturizers fully. This case underscores the need for alternative therapies in SD treatment, highlighting the role of exosomes as a viable option., (© 2024 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)

Dermatologic concerns are discussed in about a third of all primary care visits. This review discusses treatments for common dermatologic diagnoses addressed in primary care settings, with an emphasis on new and emerging treatments. Topical, oral, and injectable treatment of common forms of alopecia, facial rashes, atopic dermatitis, psoriasis, seborrheic dermatitis, and stasis dermatitis will be discussed to help increase comfort in prescribing and alert providers to common side effects or complications of more intensive treatments used by dermatologists., Competing Interests: Disclosure The authors have no conflicts of interest to report including no financial conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: Seborrheic dermatitis (SD) is a common, chronic inflammatory skin condition associated with significant impact on quality of life, yet its etiology and pathophysiology are not well understood. With significant impact on patients' quality of life, understanding the diagnostic pathway from the perspectives of patient and healthcare providers (HCPs) is crucial., Methods: An online survey was developed and administered in conjunction with the Harris Poll to gain insight into patient and HCP perspectives about SD diagnosis and management from December 2021 to January 2022., Results: Most patients were unaware of SD before their diagnosis (71%) and experienced difficulty finding information online (56%). Patients delayed seeking medical attention for SD by an average of 3.6 years, with most patients feeling their symptoms did not require medical attention (63%), a perception that HCPs correctly anticipated. Additionally, most patients (58%) reported embarrassment discussing their SD symptoms with HCPs, a factor HCPs underestimated. HCPs also underestimated the percentage of patients self-reporting moderate-severity SD. Patients preferred dermatology HCPs for SD treatment (79%), and reported visiting an average of 2.3 different HCPs, with 75% of patients seeing more than one provider., Conclusion: These insights highlight the complexities in the diagnostic and management pathways of SD and underscore the need for a more nuanced understanding and approach in addressing the condition. Infographic available for this article. INFOGRAPHIC., (© 2024. The Author(s).)

Red scalp is a common complaint that may constitute a diagnostic and therapeutic challenge in daily clinical practice. Among the numerous diseases to cause diffuse scalp erythema are psoriasis, seborrhoeic dermatitis, contact dermatitis, diffuse lichen planopilaris, dermatomyositis and scalp rosacea. Accurate diagnosis is crucial for optimal treatment outcomes. Histology most frequently discriminates the underlying condition, but it requires scalp biopsy. In many cases, the combination of clinical examination and trichoscopy is sufficient for establishing the correct diagnosis. The main trichoscopic features of psoriasis are silver-white scaling, regularly distributed dotted (glomerular) vessels or twisted red loops, and punctate haemorrhages. Yellowish-white scaling and thin arborizing vessels are typical features of seborrhoeic dermatitis. Contact dermatitis is characterized by the presence of yellow exudate and polymorphic vessels, while perifollicular scaling and erythema with the lack of follicular openings are typical findings in lichen planopilaris. In scalp dermatomyositis, tortuous and arborizing vessels with interfollicular and perifollicular pigmentation may be detected. The most characteristic features of scalp rosacea are perifollicular scaling and polygonal/arborizing vessels. This review also summarizes histological features and therapeutic options for these conditions., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (© The Author(s) 2023. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Seborrheic dermatitis is an inflammatory condition that usually presents with erythema, scaly greasy papules, and plaques affecting sebaceous gland-rich areas and predominantly involving the face and scalp. The diagnosis of seborrheic dermatitis can often be rendered based on the clinical presentation. However, in certain cases, a biopsy can be useful to distinguish it from clinical mimics such as psoriasis, discoid lupus, and rosacea. Prominent sebaceous gland atrophy without scarring has been well-described as an important and relatively specific clue for psoriatic or drug-induced alopecia. However, sebaceous gland atrophy is not specific to psoriasis and has been demonstrated in seborrheic dermatitis, facial discoid dermatitis, and potentially may occur in other inflammatory dermatoses of the scalp. We report a 23-year-old female patient presenting with non-scarring hair loss and histopathological findings demonstrating mild androgenetic alopecia and changes of seborrheic dermatitis with dramatic sebaceous gland atrophy. The patient had no history or evidence of psoriasis clinically. Our case suggests that in patients with seborrheic dermatitis, sebaceous gland atrophy may complicate the evaluation of alopecia biopsies and should be recognized as a pitfall. Seborrheic dermatitis should be included in the differential diagnosis of alopecia biopsies showing prominent sebaceous gland atrophy., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Atopic dermatitis (AD) is a chronic, recurring, inflammatory skin condition. Xerosis, pruritus, and rash make the clinical diagnosis. Adequate skin care and regular emollient use are key in management. Topical corticosteroids are the first-line treatment for AD flare-ups. Wet wrap therapy can improve AD severity and extent. Topical calcineurin inhibitors are second-line treatments. Emollient use, topical corticosteroids and calcineurin inhibitors, and bleach baths can help prevent flare-ups. Patients with refractory AD that might require immunomodulatory treatments, such as dupilumab (Dupixent), Janus kinase inhibitors, or phototherapy, should be referred to a dermatologist. Seborrheic dermatitis (SD) is a common, chronic, relapsing, inflammatory condition that involves sebaceous skin areas. Infection with Malassezia species and the inflammatory response to it are the probable etiologies. The clinical diagnosis is made by the presence of hallmark greasy, yellow scales on the scalp or face. Infantile SD most commonly involves the scalp and forehead and typically is self-limited. In infants, application of emollients followed by hair brushing and shampooing may be effective. In infants and children, if the condition does not improve with this treatment, topical ketoconazole shampoo, gel, or lotion is safe and effective. Refractory cases of SD can be managed with topical corticosteroids and calcineurin inhibitors.

Skin ageing is a multifaceted process impacted by both intrinsic and extrinsic factors. Drier and less elastic skin with declining sebum levels in older age makes ageing skin more vulnerable to various skin conditions, including infections, inflammatory dermatoses, and cancers. Skin problems are common among older adults due to the effects of ageing, polypharmacy and multimorbidity impacting not only physical health but wellbeing and quality of life. In the UK, older adults in geriatric medicine wards may present with various skin conditions. Hospitalised older individuals may have undiagnosed skin problems unrelated to their admission, making hospitalisation an opportunity to manage unmet needs. Asteatotic eczema, incontinence associated dermatitis, seborrhoeic dermatitis, chronic venous insufficiency, and cellulitis are common disorders clinicians encounter in the geriatric medicine wards. This article outlines the importance of performing comprehensive skin assessments to help diagnose and commence management for these common conditions.

Seborrheic dermatitis (SD) is a common skin disease with signs and symptoms that may vary by skin color, associated medical conditions, environmental factors, and vehicle preference. Diagnosis of SD is based on presence of flaky, "greasy" patches, and/or thin plaques accompanied by erythema of the scalp, face, ears, chest, and groin and is associated with pruritus in many patients. The presentation may vary in different skin types and hyper- or hypopigmentation may occur, with or without erythema and minimal or no scaling. While the pathogenesis is not certain, 3 key factors generally agreed upon include lipid secretion by sebaceous glands, Malassezia spp. colonization, and some form of immunologic dysregulation that predisposes the patient to SD. Treatment involves reducing proliferation of, and inflammatory response to, Malassezia spp. Topical therapies, including antifungal agents and low potency corticosteroids, are the mainstay of treatment but may be limited by efficacy and side effects. Few novel treatments for SD are currently being studied; however, clinical trials assessing the use of topical phosphodiesterase-4 inhibitors have been completed. Improving outcomes in SD requires recognizing patient-specific manifestations/locations of the disease, including increased awareness of how it affects people of all skin types., Competing Interests: Conflicts of interest Dr Jackson received research, honoraria, consulting, and/or other support from the following companies over the last 12 months: AbbVie, Arcutis, BMS, Dermavant, Evommune, Janssen, Lilly, Novartis, Pfizer, Regeneron, Sanofi, and UCB. Dr Alexis received grants (funds to institution) from Leo, Novartis, Almirall, Bristol-Myers-Squibb, Amgen, Menlo, Galderma, Valeant (Bausch Health), Cara, Arcutis, Dermavant; Advisory board/Consulting: Leo, Galderma, Pfizer, Sanofi-Regeneron, Dermavant, Beiersdorf, Valeant, L'Oreal, BMS, Bausch Health, UCB, Vyne, Arcutis, Janssen, Allergan, Almirall, AbbVie, Sol-Gel , Amgen, VisualDx, Eli Lilly, Swiss American; Speaker: Regeneron, Sanofi-Genzyme, Pfizer, and BMS. Dr Zirwas received research, honoraria, consulting, and/or other support from the following companies: AbbVie, All Free Clear/Sun, Anaptys Bio, Arcutis, Asana, AsepticMD, Avillion, Bausch Health, Cara, Concert, Dermavant, Edessa Biotech, EPI Health, Fit Bit, Galderma, Genentech/Novartis, Incyte, Janssen, L'Oreal, Leo, Level-Ex, Lilly, LUUM, Oculus, Peloton, Pfizer, Regeneron/Sanofi, Sol-Gel, Trevi, UCB, and Vyne. Dr Taylor serves on the Board of Directors and receives honoraria from CannTec; serves on advisory boards, is a consultant, and/or speaker/faculty education and receives honoraria and/or stock options from AbbVie, Arcutis Biotherapeutics, Inc, Armis Scientific, Beiersdorf, Inc, Biorez, Inc, Cara Therapeutics, EPI Pharma, Evolus, Inc, Galderma Laboratories, L.P., GloGetter, Hugel America, Inc, Janssen, Johnson & Johnson Consumer Products Company, L'Oreal USA, Medscape/WebMD, Piction Health, Scientis U.S., UCB, and Vichy Laboratoires; is a speaker/faculty education with no compensation for Evolus, Inc, and L'Oreal USA; is on the editorial board and reports no compensation for Practical Dermatology, Cutis, and Archives in Dermatologic Research; is an author and receives book royalties from McGraw-Hill; is an investigator and reports no compensation for Concert Pharmaceuticals, Croma-Pharma, Eli Lilly, Pfizer Investigator; and reports a spouse is an employee of and receives a salary from CannTec., (Copyright © 2022 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Inflammatory skin conditions affect people of all ages, genders, and races. These common conditions are frequent causes of visits to the dermatologist. The geriatric population is often afflicted by these conditions because many are chronic and relapsing diseases. These inflammatory conditions include but are not limited to psoriasis, atopic dermatitis, contact dermatitis, seborrheic dermatitis, rosacea, and Grover disease. Chronic inflammatory skin conditions place a large burden on the health care system in the United States and have many associated comorbidities. This article discusses these inflammatory dermatoses that affect the geriatric population and common therapeutic options., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Recently, a new cryotherapy device that precisely controls skin temperature was developed. Precision cryotherapy (PC) can be a safe and alternative treatment modality for immune-related skin diseases that are difficult to treat by conventional cryotherapy because of serious adverse events., Objective: To evaluate the efficacy and safety of PC in scalp seborrheic dermatitis (SD)., Methods: A single-arm, prospective trial was designed. Twenty-four patients with SD underwent 3 PC interventions 2 weeks apart. At the baseline, Week 6, and Week 8, overall improvements in Physician Global Assessment (PGA) and clinical severity scores were assessed. At each visit, the erythema index (EI) and transepidermal water loss were evaluated. The patients scored 9 subjective symptoms using a visual analog scale (VAS)., Results: The itch VAS score decreased by 50.4% at Week 8. Blinded investigators reported improvement of PGA scores from 2.86 ± 0.62 to 1.66 ± 0.61 and clinical severity scores from 4.55 ± 1.30 to 2.45 ± 1.37. The average EI decreased by 19.6% at Week 8 ( p < .05)., Conclusion: This study not only demonstrated the efficacy and safety of PC in scalp SD but it also revealed insights for PC being a promising treatment modality in immune-related skin diseases., (Copyright © 2023 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Seborrheic dermatitis (SD) is a common, chronic inflammatory skin disease that affects the sebaceous tissues of the body. The meibomian glands of the eyelids are modified sebaceous glands. Involvement of the meibomian glands and their dysfunctioning are significant in SD; however, the ophthalmic features of SD have been poorly described in the literature. The ophthalmic manifestations of SD and the significance of ocular examinations in SD patients are discussed in this review.

Seborrheic dermatitis (SD) is a common, burdensome inflammatory skin disorder. Little is known about the identity and quality of videos patients consume on social media to better understand and manage SD. We evaluated three social media platforms-YouTube, TikTok, and Instagram-for content, quality, and popularity. Search terms "seborrheic dermatitis," "dandruff," "cradle cap," and "flaky scalp" identified videos on each platform. The first 50 videos for each keyword were analyzed. After screening, 147 YouTube, 132 Instagram, and 164 TikTok videos were included. Videos were characterized by upload source (healthcare provider/organization [HCP]/non-HCP), quality (accurate/misleading/non-informative), content (educational/personal xperience/entertainment/advertisement), and number of likes/views. Data were analyzed by chi square (categorical) or Kruskal-Wallis (continuous) tests. YouTube contained a higher proportion of videos vs. TikTok and Instagram that were made by HCPs (42.2/19.7/17.7%, respectively) and contained more accurate (52.4/28.0/32.9%), and educational (66.7/38.6/34.4%) content (p < 0.0001 for all). Non-HCPs were responsible for creating the majority of videos across platforms along with most inaccurate/non-informative (65.9/86.8/78.6%) and non-educational (56.5/75.5/71.1%) content (p < 0.0001 for all). Despite lower quality of content and information, TikTok videos had the highest mean views (2,418,872) and likes (184,395) (p < 0.0001 for all). HCP vs. non-HCP-made videos were viewed more frequently only on YouTube. Though views and likes were common for all inaccurate and entertainment/advertisement content, they were most characteristic of TikTok and Instagram (p < 0.0001). These results show a high volume of SD video consumption across all platforms, especially those with lower quality and less informative content, and significant content difference across platforms. Additional studies are needed to better characterize online SD educational content and optimize HCP-led video creation and patient video consumption., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Although rosacea and seborrheic dermatitis share some symptoms of sensitive skin, whether they respond differently to lactic acid sting and capsaicin tests, common tests for diagnosis of sensitive skin, is unknown., Objectives: To reveal the cutaneous responses to lactic acid sting (LAST) and capsaicin test (CAT) in females with either rosacea vs. seborrheic dermatitis., Methods: A total of 60 patients with rosacea, 20 patients with seborrheic dermatitis and 40 normal controls were enrolled in the study. Their skin sensitivity to stimuli were evaluated following topical application of either 10% lactic acid solution or 0.001% capsaicin solution. Transepidermal water loss (TEWL) rates and erythema indexes were also measured on the face., Results: In comparison to normal controls, the positive rate to either LAST or CAT was significantly higher in subjects with rosacea (p < 0.001), but not in that with seborrheic dermatitis. Similarly, individuals with rosacea displayed a higher positive rate to both LAST and CAT than those with seborrheic dermatitis and normal controls (p < 0.001). In parallel, the LAST scores and CAT scores in individuals with rosacea were significantly higher than in that with either seborrheic dermatitis or normal controls (p < 0.001). The baseline TEWL rates and erythema indexes were higher in individual with rosacea than in normal controls (p < 0.001). But the baseline TEWL rates and erythema indexes did not differ significantly between subjects with rosacea and that with seborrheic dermatitis. Moreover, LAST scores and CAT scores correlated positively with TEWL (p < 0.0001). TEWL rates were higher in CAT positive than in CAT negative subjects (p < 0.0001). Finally, erythema index correlated positively with CAT scores (p < 0.0001), but not with LAST scores (p = 0.0842)., Conclusions: Skin responses to LAST and CAT differ between individuals with rosacea and those with seborrheic dermatitis, possibly due to the differences in epidermal permeability barrier and the neurovascular hyperreactivity. The higher LAST and CAT scores, as well as positive rates of both LAST and CAT can be attributable to inferior permeability barrier and the neurovascular hyperreactivity in subjects with rosacea., (© 2023 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)

Tinea capitis, folliculitis, seborrheic dermatitis, and pediculosis capitis are four common scalp conditions. Although tinea capitis and seborrheic dermatitis are found more commonly in patients with skin of color and highly textured hair, all of these conditions have special diagnostic or management considerations in these populations. This article reviews the diagnosis and management of these common scalp conditions., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Sensitive scalp is sensitive skin located on the scalp. Sensitivity is considered primary in the absence of an associated scalp disorder and secondary when caused by conditions such as psoriasis, seborrheic dermatitis, and atopic dermatitis. The clinical manifestations of primary sensitive scalp are subjective. Common presenting symptoms are burning, itching, trichodynia, and dysesthesia, often coinciding with hair loss. Clinically, the skin appears normal or red. An objective diagnosis based on laboratory or histologic findings is not possible. Triggers may be endogenous (e.g., stress and emotional or psychopathological disturbances) or exogeneous (e.g., topical products and cosmetics). Treatment must be individualized. Options include pimecrolimus, hydration with hyaluronic acid, and mesotherapy with plasma rich in growth factors., (Copyright © 2022 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.)

Seborrheic dermatitis (SD) is a chronic, relapsing, inflammatory dermatosis with ambiguous pathophysiology of overcolonization of Malassezia combined with predisposing factors including sebocyte activity, impaired immunity with diminished T-cell responses and activation of complements, disruption of epidermal barrier integrity and skin microbiota, and environmental influences.

Background: Seborrheic dermatitis (SD) is a common, chronic inflammatory disease with relapses and remissions., Objectives: So we planned to investigate the relationship between SD and metabolic syndrome (Mets)., Methods: 54 patients over 18 years of age without known diabetes mellitus, hypertension, coronary artery disease who were clinically diagnosed with SD in our clinic and 47 healthy controls were included in the study. Body mass index (BMI) was calculated of all participants. Complete blood count, fasting blood sugar (FBG), triglyceride (TG), total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were examined. The relationship between the presence of MetS, disease severity, and duration was investigated., Results: Average age of patients was 35.4 (sd: 12). Average age of controls was 32.9 (sd: 10.7). MetS was detected in 35.2% (n = 19) of the patient group and 10.6% (n = 5) of the control group. The presence of MetS was higher in SD patients than in the control group (p = 0.004). The rate of people with high TG was significantly higher in the SD group than the controls (p = 0.015). HDL level was significantly lower in the patient group (p = 0.050). Systolic and diastolic blood pressure were high in patients (p = 0.016, p = 0.029)., Conclusions: Seborrheic dermatitis should be considered as a MetS marker and the presence of MetS should be examined in this group of patients. This can be helpful for the early diagnosis of a systemic disease complex with numerous complications. Also, treatment of MetS can also improve SD lesions., (© 2022 Wiley Periodicals LLC.)

Background Knowledge about cutaneous microbiota in psoriasis vulgaris and seborrheic dermatitis is limited, and a comparison of microbiota in the two diseases was not yet previously undertaken. Aims/Objectives This study aimed to compare the scalp lesional and non-lesional microbiota in psoriasis vulgaris and seborrheic dermatitis with that in a healthy control group. Methods Fifty samples were taken with sterile swabs from patients' and controls' scalps, and 16S rRNA gene sequencing analyses were performed. Results Alpha and beta diversity analyses showed that bacterial load and diversity were significantly increased in psoriasis vulgaris and seborrheic dermatitis lesions compared to the controls. As phyla, Actinobacteria decreased and Firmicutes increased, while as genera, Propionibacterium decreased; Staphylococcus, Streptococcus, Aquabacterium, Neisseria and Azospirillum increased in lesions of both diseases. Specifically, Mycobacterium, Finegoldia, Haemophilus and Ezakiella increased in psoriasis vulgaris and Enhydrobacter, Micromonospora and Leptotrichia increased in seborrheic dermatitis lesions. Mycobacterium, Ezakiella and Peptoniphilus density were higher in psoriasis vulgaris compared to seborrheic dermatitis lesions. The bacterial diversity and load values of non-lesional scalp in psoriasis vulgaris and seborrheic dermatitis lay between those of lesional areas and controls. Limitations The small sample size is the main limitation of this study. Conclusion Higher bacterial diversity was detected in lesions of both psoriasis and seborrheic dermatitis compared to the controls, but similar alterations were observed when the two diseases were compared. Although these differences could be a result rather than a cause of the two diseases, there is a need to analyze all members of the microbiota and microbiota-host interactions.

Objective: Seborrheic dermatitis (SD) is a chronic inflammatory disease. The etiology of the disease is still unknown. The systemic immune-inflammation index (SII), red cell distribution width (RDW), mean platelet volume (MPV), C-reactive protein (CRP), monocyte to HDL cholesterol ratio (MHR), platelet to lymphocyte ratio (PLR), and neutrophil to lymphocyte ratio (NLR) have all been reported as inflammatory markers in recent studies. However, these inflammatory markers have not been explored in SD patients. This study aimed to explore inflammatory and hematological parameters in SD patients with healthy controls (HCs) and evaluate their possible relationship with disease severity., Materials and Methods: One hundred patients who presented to our hospital were diagnosed with SD and 74 HCs were retrospectively included in our study. The seborrheic dermatitis area severity index (SDASI) score was used to assess the severity of the SD., Results: The patient group's mean PLR, MPV ve CRP levels were statistically significantly higher than the HCs (p < 0.05). There was no statistically significant difference in the patients compared with the control group regarding RDW, NLR, MHR, and SII levels (p > 0.05). There was no statistically significant correlation between NLR, PLR, MPV, monocyte/HDL cholesterol, SII levels with age, and SDASI in the patient group. There was a significant correlation between CRP with age and RDW with SDASI score., Conclusion: Hematological parameters and CRP are low-cost tests. These tests can be used to define inflammation levels in inflammatory diseases. This study shows that PLR, CRP, and MPV may be used as novel inflammatory markers in SD., (© 2022 Wiley Periodicals LLC.)

Papulosquamous diseases represent a commonly encountered group of cutaneous disorders in dermatology. Lesions can present with papules and plaques in various configurations, including annular forms. Some of these disorders are expected to appear in annular configurations, such as pityriasis rosea and subcorneal pustular dermatosis. Others may either begin as or even progress to annular configurations, including psoriasis vulgaris, seborrheic dermatitis, and nummular dermatitis. We have reviewed common papulosquamous diseases that can present with annular lesions, which includes psoriasis vulgaris, pityriasis rosea, subcorneal pustular dermatosis, contact dermatitis, seborrheic dermatitis, and nummular dermatitis. For each disorder, we have discussed the details of presentation and differential diseases to be considered., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Rosacea is a common chronic skin condition, but data on its epidemiology and related comorbidities are scarce., Objectives: To analyze the prevalence and associated cutaneous comorbidities of rosacea in Germany., Methods: Voluntary dermatological full-body examinations were conducted between 2001 and 2016 in more than 500 German companies by experienced dermatologists and documented electronically. Point-prevalence rates were calculated, and associations were tested with chi-squared tests and logistic regression analysis., Results: A total of 161,269 participants (mean age was 43.2 ± 10.9 years; 55.5% male) were included; 2.1% had rosacea (men: 2.1%, women 2.1%, mean age 50.7 ± 9.3 years). The prevalence of rosacea increased significantly with age (16-29 years: 0.3%; 30-39 years: 0.9%; 40-49 years: 2.0%; 50-59 years: 3.5%; 60-70 years: 5.7%). Furthermore, there was a significant decreasing prevalence from skin type I toward type IV (skin type I: 3.2%; II: 2.2%; III: 1.5%; IV: 0.4%). The most frequent dermatological comorbidities were: telangiectasia (OR = 2.5), folliculitis (OR = 1.8), seborrheic dermatitis (OR = 1.6), acne (OR = 1.6), tinea pedis (OR = 1.4), psoriasis (OR = 1.4), spider veins (OR = 1.1), and hemangioma (OR = 1.1)., Conclusions: Rosacea is a common skin condition that is most prevalent above the age of 65 years. Rosacea patients have an increased risk for associated comorbidities. Therefore, the diagnostic and therapeutic process for rosacea patients must ensure an integrated, complete dermatological approach in terms of medical care., (© 2021 The Authors. International Journal of Dermatology published by Wiley Periodicals LLC on behalf of the International Society of Dermatology.)

Background: Our knowledge of the systemic effects of seborrheic dermatitis (SD) as a chronic inflammatory skin disease remains limited. We aimed to evaluate metabolic syndrome (MS) and glucose metabolism disorders in patients with SD. Methods: The study includes 53 patients over the age of 18 diagnosed with SD and 50 age-, gender-, and body mass index-matched healthy controls. Demographic data, anthropometric measurements, blood pressure levels, family history of SD and metabolic disorder, smoking history, and severity of the disease in SD patients were obtained. Fasting plasma glucose, insulin, hemoglobin A1c, lipid profile levels, and two-hour plasma glucose in the oral glucose tolerance test (OGTT 2-h PG), homeostasis model assessment of insulin resistance (HOMA-IR), and presence of MS were determined. Results: Weight, waist circumference, family history of SD, family history of metabolic disorder, and smoking status were significantly higher in the SD group compared with the control group ( P  = 0.04, P  = 0.007, P  = 0.004, P  = 0.004, and P  = 0.048, respectively). The levels of fasting plasma insulin and triglyceride, HOMA-IR and OGTT 2-h PG were also significantly higher in the SD group than in the control group ( P  = 0.0001, P  = 0.033, P  = 0.0001, and P  = 0.049, respectively). In addition, the number of those with insulin resistance was significantly higher in the group with SD ( n  = 31, 58.49%) than in the control group ( n  = 11, 22%) ( P  = 0.0001). Although the rate of MS was higher in patients with SD ( n  = 12, 22.64%) than the controls ( n  = 6, 12%), the difference was not significant ( P  = 0.155). Conclusion: Our findings suggest an association between SD and insulin resistance, which may be due to their common inflammatory pathogenesis. This may be an indicator of susceptibility to diabetes, and these patients can be followed up for conditions associated with insulin resistance and encouraged to adopt a healthy lifestyle.

THE COMPARISONA Seborrheic dermatitis in a woman with brown-gray greasy scale, as well as petaloid papules and plaques that are especially prominent in the nasolabial folds.B Seborrheic dermatitis in a man with erythema, scale, and mild postinflammatory hypopigmentation that are especially prominent in the nasolabial folds.C Seborrheic dermatitis in a man with erythema, faint scale, and postinflammatory hypopigmentation that are especially prominent in the nasolabial folds.D Seborrheic dermatitis in a man with erythema and scale of the eyebrows and glabellar region.

Zinc pyrithione (ZnPT) is an anti-fungal drug delivered as a microparticle to skin epithelia. It is one of the most widely used ingredients worldwide in medicated shampoo for treating dandruff and seborrheic dermatitis (SD), a disorder with symptoms that include skin flaking, erythema and pruritus. SD is a multi-factorial disease driven by microbiol dysbiosis, primarily involving Malassezia yeast. Anti-fungal activity of ZnPT depends on the cutaneous availability of bioactive monomeric molecular species, occurring upon particle dissolution. The success of ZnPT as a topical therapeutic is underscored by the way it balances treatment efficacy with formulation safety. This review demonstrates how ZnPT achieves this balance, by integrating the current understanding of SD pathogenesis with an up-to-date analysis of ZnPT pharmacology, therapeutics and toxicology. ZnPT has anti-fungal activity with an average in vitro minimum inhibitory concentration of 10-15 ppm against the most abundant scalp skin Malassezia species ( Malassezia globosa and Malassezia restrica ). Efficacy is dependent on the targeted delivery of ZnPT to the skin sites where these yeasts reside, including the scalp surface and hair follicle infundibulum. Imaging and quantitative analysis tools have been fundamental for critically evaluating the therapeutic performance and safety of topical ZnPT formulations. Toxicologic investigations have focused on understanding the risk of local and systemic adverse effects following exposure from percutaneous penetration. Future research is expected to yield further advances in ZnPT formulations for SD and also include re-purposing towards a range of other dermatologic applications, which is likely to have significant clinical impact.

Background: No long-term maintenance therapy has been tested in patients with seborrheic dermatitis (SD)., Objective: We sought to compare the efficacy and tolerance of tacrolimus 0.1% ointment versus ciclopiroxolamine 1% cream as maintenance therapy for severe SD., Methods: This double-blind randomized controlled study was conducted from 2014 to 2017 in 5 Dermatology Departments and 15 dermatology practices in France. Consecutive patients with severe and chronic facial SD were included. Patients were initially treated with desonide 0.05% cream twice daily for 7 days. Patients cleared after this open phase were randomized to receive tacrolimus 0.1% or ciclopiroxolamine 1% cream 2 times a week 24 weeks. The primary endpoint was disease-free-duration, defined as the time from randomization to first relapse., Results: One hundred fourteen patients were randomized (tacrolimus, n = 57; ciclopiroxolamine, n = 57). Twelve patients relapsed in the tacrolimus group after a median delay of 91.5 days (range 15-195 days) versus 23 patients in the ciclopiroxolamine group (median delay, 27 days [range 13-201 days]). Comparison of disease-free duration curves showed that patients in the tacrolimus group had a longer duration of complete remission than those in the ciclopiroxolamine group (P = .018), corresponding to a hazard ratio of relapse of 0.44 (95% confidence interval 0.22-0.89; P = .022)., Limitations: The theoretical sample size was not reached., Conclusion: Tacrolimus 0.1% is more effective than ciclopiroxolamine 1% as maintenance therapy for patients with facial SD., (Copyright © 2020. Published by Elsevier Inc.)

Background: Eyelid dermatitis is a common dermatologic complaint., Objective: To characterize patients with eyelid dermatitis., Methods: Retrospective analysis (1994-2016) of North American Contact Dermatitis Group data., Results: Of 50,795 patients, 2332 (4.6%) had eyelid dermatitis only, whereas 1623 (3.2%) also had dermatitis of the eyelids and head or neck. Compared with patients without eyelid involvement (n = 26,130), groups with eyelid dermatitis only and dermatitis of the eyelid and head or neck were significantly more likely to be female, white, and older than 40 years, and to have a history of hay fever, atopic dermatitis, or both (P < .01). Final primary diagnoses included allergic contact dermatitis (eyelid dermatitis only: 43.4%; dermatitis of the eyelid and head or neck: 53.5%), irritant contact dermatitis (eyelid dermatitis only: 17.0%; dermatitis of the eyelid and head or neck: 9.8%), and atopic dermatitis (eyelid dermatitis only: 13.1%; dermatitis of the eyelid and head or neck: 13.8%). Top 5 currently relevant allergens included nickel sulfate (eyelid dermatitis only: 18.6%; dermatitis of the eyelid and head or neck: 22.5%), fragrance mix I (eyelid dermatitis only: 16.5%; dermatitis of the eyelid and head or neck: 18.3%), methylisothiazolinone (eyelid dermatitis only: 16.5%; dermatitis of the eyelid and head or neck: 17.7%), gold sodium thiosulfate (eyelid dermatitis only: 14.7%; dermatitis of the eyelid and head or neck: 11.4%), and balsam of Peru (eyelid dermatitis only: 11.9%; dermatitis of the eyelid and head or neck: 12.6%). Both eyelid-involvement groups were significantly more likely to react to gold sodium thiosulfate, carmine, shellac, dimethylaminopropylamine, oleamidopropyl dimethylamine, and thimerosal (P < .05) compared with the no eyelid involvement group., Limitations: Lack of specific distribution patterns of eyelid dermatitis and no long-term follow-up data., Conclusion: Patch testing remains a critical tool in evaluating patients with eyelid dermatitis., (Published by Elsevier Inc.)

Background: Hand eczema (HE) is a heterogeneous and burdensome disorder., Objective: To characterize the clinical characteristics, etiologies and allergen relevance in adults with HE referred for patch testing., Methods: Retrospective analysis (2000-2016) of North American Contact Dermatitis Group data (n = 37,113)., Results: Overall, 10,034 patients had HE, with differences of overlap between allergic contact, irritant contact, and atopic dermatitis. Allergic contact HE fluctuated, whereas atopic HE steadily increased, and irritant HE decreased over time. HE was associated with higher proportions of positive patch tests (67.5% vs 63.8%; χ 2 , P < .0001). The five most common clinically relevant allergens were methylisothiazolinone, nickel, formaldehyde, quaternium-15, and fragrance mix I. HE was associated with significantly higher odds of positive patch test reactions and clinical relevance in 13 and 16 of the 25 most common allergens, respectively, including preservatives, metals, topical medications, and rubber accelerators., Limitations: No data on HE phenotype., Conclusion: HE in adults was associated with higher proportions of positive patch tests, with a heterogeneous profile of allergens. Patch testing remains an important tool in the evaluation of patients with HE., Competing Interests: Conflicts of interest None disclosed., (Copyright © 2020 American Academy of Dermatology, Inc. All rights reserved.)

The association of hidradenitis suppurativa with other skin diseases has not yet been investigated in larger studies based on dermatological exams. The objectives of this study are to determine the prevalence and cutaneous comorbidities of hidradenitis suppurativa in the German working population. Between 2014 and 2017, 20,112 people in 343 German companies were examined for the presence of clinical features of hidradenitis suppurativa within the framework of a cross-sectional epidemiological study based on whole-body examinations. In addition, all cutaneous comorbidities were recorded. Point prevalence was calculated and the differences between individuals with and without hidradenitis suppurativa were determined by bivariate analysis. All statistical procedures were performed using SPSS 23.0 for Windows. Of 20,112 people examined, mean age was 43.6 ± 10.5 years; 52.3% were male. In total, n = 57 people (0.3%) with hidradenitis suppurativa were identified; 61.4% (n = 35) being male. In addition, non-inflammatory hidradenitis suppurativa-related lesions were found in 674 other individuals. In a bivariate comparison, patients with hidradenitis suppurativa showed significantly more frequently the following cutaneous comorbidities: acne vulgaris, psoriasis, seborrhoeic dermatitis, excoriations, and folliculitis. We determined a point prevalence of hidradenitis suppurativa of 0.3%. Since we have examined the working population, the healthy worker effect, which could have led to underestimation of prevalence, cannot be ruled out. The point prevalence of 0.3% for employed people in Germany and a prevalence of 3.0% for inflammatory and non-inflammatory hidradenitis suppurativa-related lesions show that hidradenitis suppurativa is an important disease for the whole health system.

Aim: Current quarantine conditions are a difficult process for individuals and can worsen the psychological state. Increased psychosocial stress can affect the course of many common "stress-sensitive" skin conditions. This study examined the possible effects of coronavirus disease 2019 (COVID-19) on hair and scalp diseases such as telogen effluvium (TE), alopecia areata (AA), and seborrheic dermatitis (SD) in individuals who had to stay at home for a long time and the patients' methods of dealing with these diseases., Methods: The study was conducted using an online questionnaire. All the individuals were asked questions about pre- and post-pandemic TE, AA, and SD. Participants with complaints were asked what they did for treatment., Results: During the pandemic, TE was seen in 27.9% of the participants, AA on the scalp was seen in 2.8%, AA on the face was seen in 2.5%, and SD was seen in 19.9%. Applying to a dermatologist for complaints during the pandemic was lower than before pandemic. TE was higher in women before and during the pandemic., Conclusion: It was found that the rates of referring to a dermatologist for the complaints before the pandemic varied between 15% and 28% and that these rates decreased significantly during the pandemic (2.5%-12.5%)., (© 2020 Wiley Periodicals LLC.)

Patients with flares of seborrhoeic dermatitis were compared with control outpatients seen during the same time-period in a case-control study, and with themselves while in remission in a case-crossover study. All patients consulted the same office-based dermatologist. During the study period, 189 cases and 189 controls were included in the case-control study, and 81 cases in the case-crossover study. Multivariate analysis was performed. Case-control study results were the following: past history of tobacco consumption (odds ratio (OR) 2.2 (95% confidence interval (CI) 1.1-4.6)), conflict as a dispute during the past month (OR 10.6 (95% CI 1.0-114.3)), alcohol consumption on a regular basis (OR 10.2 (95% CI 2.0-52.6)), and higher level of stress during the past month (OR 8.2 (95% CI 3.4-19.9)). Case-crossover study results were the following: higher level of stress during the past month (OR 4.5 (1.7-12.2)), association borderline significant for higher level of alcohol consumption (OR 5.4 (0.8-34.9)). These risk factors for flares of seborrhoeic dermatitis should be taken into account carefully in the daily management of seborrhoeic dermatitis.

Background: Although the majority of rashes in the diaper area are caused by irritation from urine and feces, irritant diaper dermatitis; IDD, there are some less common but potentially serious cutaneous eruptions associated with systemic diseases that should not be discounted., Methods: This prospective descriptive study aimed to explore variation in cutaneous disease in the diaper area. It was conducted as a prospective descriptive study between October 2016 and November 2019 in the pediatric department of a tertiary-level hospital., Results: Three hundred consecutive patients with rashes in the diaper area were enrolled. The most common diagnosed was IDD (125 cases; 41.7%), followed by rashes exacerbated by the diaper (101 cases; 33.67%) and non-diaper-related rashes (74 cases; 24.67%)., Conclusions: Our finding suggests that when diagnosing rashes that occur in the diaper area, general pediatricians should consider, in addition to IDD, the possibility of less-common conditions. The simultaneous presence of cutaneous lesions at other sites was linked to diagnoses of systemic diseases other than IDD, (P < 0.001).