6. CLINICAL AND SUBCLINICAL CHARACTERISTICS OF PATIENTS WITH MODERATE AND SEVERE SEBORRHEIC DERMATITIS

Do Thi Thu Hien1,2, Le Van Trung1, Nguyen Tran Hai Anh2
1 National Hospital of Dermatology and Venereology
2 VNU University of Medicine and Pharmacy

Main Article Content

Abstract

Objective: This study examined the clinical and subclinical characteristics of patients with moderate and severe seborrheic dermatitis (SD).


Subjects and methods: A cross-sectional descriptive study of 62 adult patients with moderate and severe seborrheic dermatitis diagnosed at the National Hospital of Dermatology & Venereology from 08/2020 to 10/2021.


Results: Seborrheic dermatitis occurred in 80.7% of males and 19.3% of females. The disease was common in patients with oily skin (69.3%). The age group of 20-49 year olds was mostly affected (80.7%). The average age of onset was 32.1 ± 12.6 years, and the average duration of disease was 3.9 ± 2.8 years. All patients with moderate and severe seborrheic dermatitis had basic lesions of erythema and scales. The main subjective symptoms were itching (100%) and burning sensation (87.1%). Lesions were scattered with indistinct or absent borders. The most affected sites were the facial area (75.8%) and scalp (71%). Seborrheic dermatitis was often accompanied by pityriasis versicolor (21%). The proportion of patients with moderate and severe seborrheic dermatitis had more than 20 Malassezia spores per field under KOH examination was 19.4%. The density of Malassezia in patients with severe SD was higher than in moderate SD but the difference was not statistical significance.


Conclusion: Seborrheic dermatitis was commonly seen in male patients with oily skin. The most common skin lesions were erythema and scales, located on the scalp and face, with scattered distribution and indistinct borders. Malassezia density was higher in patients with severe SD than in moderate SD but not statisically significant.

Article Details

References

[1] Ak G, R B. Seborrheic dermatitis. Journal of the
European Academy of Dermatology and
Venereology : JEADV. doi:10.1111/j.1468-
3083.2004.00693.x
[2] Dessinioti C, Katsambas A, Seborrheic
dermatitis: etiology, risk factors, and treatments:
facts and controversies. Clin Dermatol. 2013;
31(4):343-351.
doi:10.1016/j.clindermatol.2013.01.001
[3] Ijaz N, Fitzgerald D, Seborrhoeic dermatitis. Br
J Hosp Med (Lond). 2017;78(6):C88-C91.
doi:10.12968/hmed.2017.78.6.C88
[4] Peyrí J, Lleonart M, Grupo español del Estudio
SEBDERM. [Clinical and therapeutic profile and
quality of life of patients with seborrheic dermatitis].
Actas Dermosifiliogr. 2007;98(7):476-482.
[5] Lê Anh Tuấn, Nghiên cứu tình hình, đặc điểm
lâm sàng, một số yếu tố liên quan và kết quả
điều trị viêm da dầu bằng kem ketoconazole và
kem corticoid. Luận văn thạc sĩ y học, Trường
đại học Y Hà Nội, 2006.
[6] Faergemann J, Johansson S, Bäck O et al., An
immunologic and cultural study of Pityrosporum
folliculitis. J Am Acad Dermatol. 1986;14(3):429-
433. doi:10.1016/s0190-9622(86)70053-4
[7] Sunenshine PJ, Schwartz RA, Janniger CK,
Tinea versicolor: an update. Cutis. 1998;61(2):
65-68, 71-72.
[8] Zug KA, Palay DA, Rock B, Dermatologic
diagnosis and treatment of itchy red eyelids.
Surv Ophthalmol. 1996;40(4):293-306.
doi:10.1016/s0039-6257(96)82004-2
[9] Gupta AK: A random survey concerning aspects
of acne rosacea (abstract). J Cutan Med Surg
2001;5:38.
[10] Misery L, Touboul S, Vinçot C et al., [Stress
and seborrheic dermatitis]. Ann Dermatol
Venereol. 2007;134(11):833-837. doi:10.1016/
s0151-9638(07)92826-4
[11] Tajima M, Sugita T, Nishikawa A et al.,
Molecular analysis of Malassezia microflora in
seborrheic dermatitis patients: comparison with
other diseases and healthy subjects. J Invest
Dermatol. 2008;128(2):345-351. doi:10.1038/
sj.jid.5701017
[12] Zaidi Z, Wahid Z, Cochinwala R et al., Correlation
of the density of yeast Malassezia with the clinical
severity of seborrhoeic dermatitis. J Pak Med
Assoc, 2002;52(11):504-506.
[13] Shemer A, Kaplan B, Nathansohn N et al.,
Treatment of moderate to severe facial
seborrheic dermatitis with itraconazole: an open
non-comparative study. Isr Med Assoc J.
2008;10(6):417-418.
[14] Nguyễn Hữu Sáu, Trần Cẩm Vân và cộng sự,
Nghiên cứu ứng dụng một số kỹ thuật chẩn đoán
xác định chủng nấm Malassezia gây bệnh lang
ben tại khu vực Hà Nội. Đề tài cấp thành phố,
Hà Nội, 2018.
[15] Hoàng Thị Phượng, Đặc điểm lâm sàng, các yếu
tố liên quan và kết quả điều trị viêm da dầu bằng
uống vitamin A acid kết hợp bôi mỡ tacrolimus
0,1%. Luận văn thạc sĩ y học, Trường Đại học Y
Hà Nội, 2011.
[16] Baysal V, Yildirim M, Ozcanli C et al.,
Itraconazole in the treatment of seborrheic
dermatitis: a new treatment modality. Int J
Dermatol. 2004;43(1):63-66. doi:10.1111/j.
1365-4632.2004.02123.x
[17] Thomas P Habif et al., Seborrheic dermatitis. Skin
disease. Mosby publishing: 2005: p.116-119.
[18] Thomas B.Fitzpatrick. Seborrheic dermatitis.
Dermatology in General Medicine. Mosby
publishing: 1987: p.978-981.