An immunological study in patients with seborrhoeic dermatitis

Abstract

The humoral and cellular immune-status was studied in 30 patients with seborrhoeic dermatitis. Increased frequencies of natural killer cells were found in 46% of patients. Furthermore, subnormal mitogen stimulation responses were demonstrated in 13 patients, whereas two individuals were found to have very high numbers of activated T lymphocytes in peripheral blood. Higher-than-normal total serum IgG and IgA was observed in 14 and 11 patients, respectively. For nine of 12 patients with skin lesions, dermal perivascular cell infiltrates were seen. The majority of the infiltrating cells reacted with anti-CD4 antibodies. HLA-DR-expressing keratinocytes were found in two biopsies. The study suggests that patients with seborrhoeic dermatitis may have depressed T-cell function. This could have a bearing on their susceptibility to the Pityrosporum ovale-associated dermatitis. The very high frequencies of activated T cells observed in the peripheral blood of two otherwise healthy seborrhoeic individuals suggests that intermittent systemic immune activation may occur. Seborrhoeic dermatitis is a common skin disease. It can be diagnosed by its characteristic red to yellow-brown lesions covered with greasy scales distributed in areas with a high number of sebaceous glands, such as the scalp, face and upper trunk. There is an association between seborrhoeic dermatitis and the lipophilic yeast Pityrosporum ovale but its exact aetiological role is not known. The yeast is a member of the normal cutaneous flora but also the aetiological agent of pityriasis versicolor and Pityrosporum folliculitis. P. ovale can activate complement via the direct and alternative pathways. This may play some part in the induction of inflammation.(ABSTRACT TRUNCATED AT 250 WORDS)

Immunology of Diseases Associated withMalasseziaSpecies

“…An early histological study of SD demonstrated the presence of lymphocytes within lesions (335), and this was confirmed later when they were identified as mainly Th CD4-positive cells (51). Langerhans' cell numbers were not increased in lesional skin, and HLA-DR expression on keratinocytes was noted only infrequently (51). An extensive study recently found the infiltrate to consist of lymphocytes, macrophages, monocytes, and Langerhans' cells, with a few granulocytes (131).…”

“…Many groups have found no differences in IgG titers to Malassezia between patients with SD and controls despite studying larger numbers of subjects (49,51,176,219).…”

Pityrosporum species as a cause of allergy and infection

“…In peripheral blood from a high number of patients with seborrheic dermatitis, we found an increase in the number of natural killer cells and decreased phytohemagglutinin and concanavalin A stimulation (29,30).…”

Childhood indicators of susceptibility to subsequent cervical cancer

“…The lack of association with hay fever suggests that the eczema predictive of subsequent cervical cancer occurs both in atopic and non-atopic women. This may be seborrhoeic eczema, which is possibly due to an inability to control yeast colonisation and individuals with this type of eczema may have depressed T-cell function (Bergbrant et al, 1991).…”