Comparison of Clinical Manifestations and Distribution of Malassezia Species in Patients with Seborrheic Dermatitis and Atopic Dermatitis

Hwang, Sung Joo; Lee, Sung Hoon; Kim, Do Won; Jun, Jae Bok; Chung, Sang Lip; Jung, Hyeon Joo

Abstract

BACKGROUND: Seborrheic dermatitis and atopic dermatitis are clinically different diseases, but symptoms and signs of both seborrheic dermatitis and atopic dermatitis often can be found simultaneously in one patient.
OBJECTIVE
The aim of this study was to (1) investigate if patients with either seborrheic dermatitis or atopic dermatitis have the symptoms and signs of both disease entities at the same time, and (2) study the relationship between Malassezia species on the scalp and each of the diseases. METHOD: Eighty five patients with seborrheic dermatitis on the scalp, the Pityriasis sicca type, and 79 patients with atopic dermatitis and 76 normal subjects were observed clinically by the dermatologist and studied statistically using questionaires. A mycological study of Malassezia species was also performed by direct smearing. RESULT: Among the 21 items of questionaires regarding the symptoms and signs of seborrheic dermatitis, the patients with atopic dermatitis showed higher incidences in 7 items compared with normal subjects, and among the 22 items of questionaires regarding the symptoms and signs of atopic dermatitis, the patients with seborrheic dermatitis showed higher incidences in 2 items than the normal subjects. The patients regarded their skin conditions as follows : the mixed state of dried and oily skin was in 32.9% of the patients with atopic dermatitis, 42.4% of those with seborrheic dermatitis, and 43.4% of the normal subjects. On clinical grading by the Kligman's scale, the most common grade was below grade II(no scaling) in patients with atopic dermatitis and grade III(slight scaling) in patients with seborrheic dermatitis, respectively. The spores of Malassezia species were found in 83.6% of the patients with atopic dermatitis, 96.2% of those with seborrheic dermatitis, and 90.6% of the normal subjects.
CONCLUSION
According to the results of the study, the patients with atopic dermatitis showed higher incidences of symptoms and signs of seborrheic dermatitis than normal subjects and there was no difference in the number of spores and hyphae of Malassezia species among the three groups. Further studies will be needed to elucidate the relationship between sebonheic dermatitis and atopic dermatitis.