Kamamoto C S L, Nishikaku A S, Gompertz O F, Melo A S, Hassun K M, Bagatin E
Department of Dermatology, Federal University of Sao Paulo (UNIFESP), São Paulo, SP, Brazil.
Department of Medicine, Special Mycology Laboratory, Federal University of Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil.
Dermatoendocrinol. 2017 Oct 23;9(1):e1361573. doi: 10.1080/19381980.2017.1361573. eCollection 2017.
spp in skin microbiome scalp has been implicated in seborrheic dermatitis pathogenesis. Thus, treatment based in antifungal combined to topical keratolitic agents have been indicated as well as oral isotretinoin as it reduces the sebum production, glandular's size and possesses anti-inflammatory properties. This randomized, comparative and therapeutic trial aimed toper form the genotypic identification of species before and after low-dose oral isotretinoin or topical antifungal treatments for moderate to severe seborrhea and/or seborrheic dermatitis on scalp. Scales and sebum of the scalp were seeded in the middle of modified Dixon and incubated at 32°C. For genotypic identification polymerase chain reaction primers for the ITS and D1/D2 ribossomal DNA were used and followed by samples sequencing. The procedure was conducted before and after therapeutic and randomized intervention for moderate to severe seborrhea/seborrheic dermatitis on the scalp, including oral isotretinoin, 10 mg, every other day and anti-seborrheic shampoo (piroctone olamine), over six months. The and were the most frequent species isolated on the scalp before and after both treatments. Other non- species were also identified. The spp. were maintained in the scalp after both treatments that were equally effective for the control of seborrhea/seborrheic dermatitis clinical signs.
皮肤微生物群中的马拉色菌属已被认为与脂溢性皮炎的发病机制有关。因此，已表明基于抗真菌联合局部角质剥脱剂的治疗以及口服异维A酸是有效的，因为它可减少皮脂分泌、缩小腺体大小并具有抗炎特性。这项随机、对照治疗试验旨在对中重度头皮脂溢和/或脂溢性皮炎患者在低剂量口服异维A酸或局部抗真菌治疗前后的马拉色菌种进行基因分型鉴定。将头皮鳞屑和皮脂接种于改良Dixon培养基中部，在32℃下培养。使用针对ITS和D1/D2核糖体DNA的聚合酶链反应引物进行基因分型鉴定，随后对样本进行测序。该程序在对中重度头皮脂溢/脂溢性皮炎进行治疗性随机干预（包括每隔一天口服10mg异维A酸和使用去屑洗发水（吡硫翁锌））前后进行，为期六个月。两种治疗前后，马拉色菌属都是头皮上最常分离出的菌种。还鉴定出了其他非马拉色菌属菌种。两种治疗对控制脂溢/脂溢性皮炎临床症状同样有效，治疗后马拉色菌属菌种仍存在于头皮上。
