engleski

Contact allergy in seborrhoeic dermatitis.

Background: During the last years, we noticed that some patients with seborrhoeic dermatitis had resistant clinical picture although they were on appropriate therapy. History data from most of our patients revealed a short or prolonged use of corticosteroid (C) topicals. It was the aim of the study to examine the occurrence of contact sensitivity in seborrhoeic dermatitis (SD) patients. Methods: We followed 100 patients, 50 with SD, and 50 SD that were using local corticosteroids approximately 1 month to 1 year (SDC), as well as 20 healthy controls. Age range was from 11 to 83 years. Mycology analysis for yeast Malassezia furfur (P. ovale) was performed. Patch tests were carried out according to ICDRG with standard serious of allergens, commercial corticosteroid allergens, self-use-corticosteroid panel and the yeast P. ovale. Chi-square method and Z statistics were used for evaluating differences between groups. Results: There were 25 males and 95 females, mean age 45 years. Malassezia furfur (P. ovale) was revealed in 44 (88%) SD, 37 (74%) SDC, and in 4 (20%) healthy controls. Patch test to P. ovale was positive in 1 (2%) SD, and in 3 (6%) SDC patients. In patch tests to standard allergen panel 17 (34%) SD, 33 (66%) SDC patients and 2(10%) healthy controls had positive reactions. Most positive reactions were to nickel-sulfate 18(15%) in all three investigated groups, followed by carbamix 13 (10, 8%), cobalt chloride 11 (9, 2%), neomycin-sulfate 8 (4, 2%). In patch test to corticosteroid commercial panel, positive reaction were seen in 4 (3%) SDC patients, mostly to betamethasone-17-valerate-3, clobetasole-17-propionate-2, hydrocortisone-17-butyrate-2, budesonide-2, tixocortole-21-pivalate-2, and amcinonid-1. In patch test to self-use-corticosteroid panel positive reactions were seen in 7 (6, 0%) patients, 2 (1, 7%) SD, and 5 (7, 5%) SDC, preferably to alclomethasone -2, betamethasone-2 and momethasone-2. Conclusion: One of the possible etiological causes of SD is Malassezia furfur (P. ovale). It is known that the effects of corticosteroids influence the detection of Malassezia furfur (P. ovale) depending on the length of usage. There were higher frequencies of positive reactions in patch test to standard panel allergens in SDC patients compared to findings in SD and healthy controls. There were higher frequencies of positive patch tests in SDC patients with increasing length of C usage. Positive reactions to corticosteroids were mostly seen in SDC patients. Mycology analyses and patch tests to standard allergens as well as corticosteroids should be performed in SD patients with persistent skin lesions.

Contact allergy seborrhoeic dermatitis

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