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Pityrosporum ovale in infantile seborrheic dermatitis
R Ruiz-Maldonado1, R López-Matínez, E L Pérez Chavarría
1Department of Dermatology, Instituto Nacional de Pediatría, México City.
Insights
Pityrosporum ovale was significantly more common in infants with seborrheic dermatitis. Topical ketoconazole cream effectively treated infantile seborrheic dermatitis, clearing most cases.
Area of Science:
- Dermatology
- Mycology
- Pediatrics
Background:
- Infantile seborrheic dermatitis (ISD) is a common skin condition in infants.
- The role of Pityrosporum ovale (P. ovale) in ISD pathogenesis is debated.
- Understanding P. ovale prevalence is crucial for diagnosing and treating infant dermatoses.
Purpose of the Study:
- To investigate the prevalence of P. ovale in infants with ISD compared to other dermatoses and healthy controls.
- To evaluate the efficacy of topical ketoconazole in treating ISD.
Main Methods:
- A study involving four groups of infants (1-24 months): ISD, atopic dermatitis, other dermatoses, and healthy controls.
- Samples collected from scalp, face, presternal, and inguinal areas for P. ovale detection via smears and/or cultures.
- ISD patients received 2% topical ketoconazole cream for two weeks.
Main Results:
- P. ovale was detected in 73% of infants with ISD, significantly higher than in atopic dermatitis (33%), other dermatoses (33%), and healthy infants (53%).
- Positive P. ovale detection rates were 42% for ISD, 20% for atopic dermatitis, 20% for other dermatoses, and 23% for healthy infants across body sites.
- Topical ketoconazole treatment led to clinical clearance in 11 infants and mycological negativity in 13 infants with ISD.
Conclusions:
- Pityrosporum ovale is significantly more prevalent in infants with seborrheic dermatitis compared to other groups.
- Topical ketoconazole is an effective treatment for infantile seborrheic dermatitis.
- These findings support a role for P. ovale in the etiology of infantile seborrheic dermatitis.
Abstract:
The presence of Pityrosporum ovale was investigated in four groups of infants age 1 to 24 months, 15 with infantile seborrheic dermatitis, 15 with infantile atopic dermatitis, 15 with other infantile dermatoses, and 15 healthy infants. Samples were taken from the scalp, face, presternal area, and inguinal area. Pityrosporum ovale was detected by smears and/or cultures in 73% of infants with seborrheic dermatitis, 33% with atopic dermatitis, 33% with other dermatoses, and 53% of healthy infants. The percentages of positive smears and/or cultures from four body sites in each patient group were 42% for seborrheic dermatitis, 20% for atopic dermatitis, 20% for other infantile dermatoses, and 23% for healthy infants. The majority of infants with positive cultures or positive direct examination for P. ovale were between 1 and 8 months of age. The organism was isolated in 28% of samples taken from the scalp, 32% from the face, 30% from the presternal area, and 15% from the inguinal area. Patients with infantile seborrheic dermatitis were treated with 2% topical ketoconazole cream for two weeks. Eleven of these children were clinically cleared and 13 became mycologically negative. Pityrosporum ovale was significantly more frequent in infants with seborrheic dermatitis than in those with atopic dermatitis, in other infantile dermatoses, or in healthy infants, both in the total number of infants with positive smears and/or cultures and in the number of positive samples per body area (P less than 0.05).