Contact allergy to corticosteroids and Malassezia furfur in seborrhoeic dermatitis patients

J Eur Acad Dermatol Venereol. 2011 Jun;25(6):647-51. doi: 10.1111/j.1468-3083.2010.03843.x. Epub 2010 Sep 20.

Abstract

Background: Seborrhoeic dermatitis (SD) is a chronic skin disease, requiring long-term treatment, which might promote sensitization. Malassezia furfur (Mf) plays an important role in seborrhoeic dermatitis. Objectives The aim of this study was to determine the frequency of contact sensitivity in SD patients.

Patients and methods: A total of 100 patients and 20 healthy controls (HC) were investigated: 50 suffering from SD with no previous local corticosteroid treatment (SDN), 50 SD patients treated with local corticosteroids (SDC). Mycological examination for Mf was performed. All patients were patch tested with the baseline standard, corticosteroid series, with 12 commercial corticosteroid preparations frequently used in Croatia; and also with Mf.

Results: Malassezia furfur was found in 44 (88%) SDN, 37 (74%) SDC, and in 4 (20%) HC; patch test reaction to Mf was positive in one SDN and in three SDC. Positive patch tests to standard allergens were observed in 17 (34%) SDN, 33 (66%) SDC and 2 (10%) HC. Patch tests to the corticosteroid series revealed positive reactions in 4 SDC and to commercial corticosteroids in seven patients, i.e. 2 SD and 5 SDC.

Conclusions: Patch tests to the baseline series and to both individual corticosteroid and commercial corticosteroid preparations should be performed in SD patients with persistent dermatitis, as contact-allergic reactions may complicate their dermatitis. Sensitization to Mf was found to be infrequent.

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / adverse effects*
  • Adrenal Cortex Hormones / immunology
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Dermatitis, Allergic Contact / etiology*
  • Dermatitis, Allergic Contact / immunology
  • Dermatitis, Allergic Contact / microbiology
  • Dermatitis, Seborrheic / complications*
  • Dermatitis, Seborrheic / drug therapy
  • Dermatitis, Seborrheic / immunology
  • Dermatomycoses / immunology*
  • Dermatomycoses / microbiology
  • Female
  • Humans
  • Malassezia / immunology*
  • Male
  • Middle Aged
  • Patch Tests
  • Young Adult

Substances

  • Adrenal Cortex Hormones