Bergbrant I M
Department of Dermatology, University of Göteborg, Sweden.
Acta Derm Venereol Suppl (Stockh). 1991;167:1-36.
Seborrhoeic dermatitis is a common skin disease mainly affecting the scalp and face. The etiology of seborrhoeic dermatitis is unknown but a connection with the lipophilic yeast Pityrosporum ovale has been found in a number of treatment studies. P. ovale belongs to the normal cutaneous flora but is also an opportunistic pathogen. The purpose of these studies was to examine how the density of P. ovale changes with age, to determine the number of P. ovale in seborrhoeic dermatitis compared to controls, to study the immunological functions in patients with seborrhoeic dermatitis, to evaluate different methods of detecting antibodies against P. ovale and to describe how the patients experience their disease. The number of P. ovale on clinically normal skin decreases with increasing age. In patients with seborrhoeic dermatitis, the number of P. ovale in lesional skin was not increased compared to healthy skin in the patients or in healthy controls. A reduction of the skin surface lipids was seen in elderly healthy individuals. The lipid content on the skin in patients with seborrhoeic dermatitis was higher than in controls (p = 0.0001). Serum IgG antibodies against P. ovale measured with indirect immunofluorescence decreased parallel to increasing age in healthy individuals and no difference was found between patients with seborrhoeic dermatitis and healthy controls. ELISA with a P. ovale protein extract was the only method that demonstrated a difference in immune response between patients and controls when this method was compared with four other assays (p = 0.03). Immunological screening was done in 30 patients with seborrhoeic dermatitis. No major abnormalities in the humoral and local immune system were found but T-cell and NK-cell aberrations were found in several patients with seborrhoeic dermatitis. One-third of the patients had low lymphocyte stimulations with Concanavalin-A and phytohaemagglutinin and almost half of the patients had high frequencies of circulating natural killer-cells. In a questionnaire answered by 431 patients with seborrhoeic dermatitis, we found indications that hereditary, the season, mental stress and the work environment influence the disease. The investigations suggest that the number of P. ovale in seborrhoeic dermatitis is of minor importance. How each individual reacts to P. ovale and the amount of skin surface lipids are probably of greater importance in the development of seborrhoeic dermatitis.
脂溢性皮炎是一种常见的皮肤病，主要影响头皮和面部。脂溢性皮炎的病因尚不清楚，但在一些治疗研究中发现它与亲脂性酵母卵形糠秕孢子菌有关。卵形糠秕孢子菌属于正常皮肤菌群，但也是一种机会致病菌。这些研究的目的是研究卵形糠秕孢子菌的密度如何随年龄变化，确定脂溢性皮炎患者与对照组相比卵形糠秕孢子菌的数量，研究脂溢性皮炎患者的免疫功能，评估检测抗卵形糠秕孢子菌抗体的不同方法，并描述患者对其疾病的感受。临床上正常皮肤表面的卵形糠秕孢子菌数量随年龄增长而减少。在脂溢性皮炎患者中，与患者自身的健康皮肤或健康对照组相比，皮损处的卵形糠秕孢子菌数量并未增加。在老年健康个体中可见皮肤表面脂质减少。脂溢性皮炎患者皮肤中的脂质含量高于对照组（p = 0.0001）。用间接免疫荧光法检测的抗卵形糠秕孢子菌血清IgG抗体在健康个体中随年龄增长而平行下降，脂溢性皮炎患者与健康对照组之间未发现差异。与其他四种检测方法相比，用卵形糠秕孢子菌蛋白提取物进行ELISA检测是唯一显示患者与对照组免疫反应存在差异的方法（p = 0.03）。对30例脂溢性皮炎患者进行了免疫筛查。未发现体液和局部免疫系统有重大异常，但在一些脂溢性皮炎患者中发现了T细胞和NK细胞异常。三分之一的患者对刀豆球蛋白A和植物血凝素的淋巴细胞刺激反应较低，近一半的患者循环自然杀伤细胞频率较高。在431例脂溢性皮炎患者回答的问卷中，我们发现有迹象表明遗传、季节、精神压力和工作环境会影响该病。研究表明，卵形糠秕孢子菌数量在脂溢性皮炎中不太重要。在脂溢性皮炎的发病过程中，个体对卵形糠秕孢子菌的反应以及皮肤表面脂质的含量可能更为重要。
