Dermatitis seboroik
-
Upload
putrisarah -
Category
Documents
-
view
9 -
download
0
description
Transcript of Dermatitis seboroik
+
Three Etiologic Facets of Dandruff and Seborrheic Dermatitis: Malassezia Fungi,
Sebaceous Lipids, and Inividual Sensitivity
Journal Reading
PUTRI SARAH030.10.225
Journal Reading Title : Three Etiologic Facets of Dandruff and Seborrheic Dermatitis: Malassezia Fungi, Sebaceous Lipids, and Individual Sensitivity Author : DeAngelis YM, Gemmer CM, Kaczvinsky JR, Kenneally DC, Schwartz JR, Dawson TL Jr The Procter & Gamble Company, Cincinnati, Ohio, USA. Journal Publisher : J Investig Dermatol Symp Proc 10:295–297, 2005Available at : http://europepmc.org/abstract/MED/16382685
+Introduction
Application of new molecular and biochemical tools has greatly increased our understanding of the organisms, mechanisms, and treatments of dandruff and seborrheic dermatitis
Dandruff results from at least three etiologic factors: Malassezia fungi, sebaceous secretions, and individual sensitivity.
Malassezia number and the presence and severity of dandruff has remained perplexing
+Malassezia fungi
Malassezia (formerly P. ovale) has long been a suspected cause, implicated by its presence on skin and lipophylic
nature
The yeast produces toxic substances that irritate and inflame the skin.
Patients with seborrhoeic dermatitis appear to have a reduced resistance to the yeast
Lack of correlation between Malassezia number and the presence and severity of dandruff has remained perplexing.
+Sebaceous LipidsThere are two types of sebaceous gland, those connected to hair follicles, in pilosebaceous units, and those that exist independently
The glands deposit sebum on the hairs, and bring it to the skin surface along the hair shaft
Secrete the oily, waxy substance called sebum
Some hormones, including androgens such as testosterone and estrogen, as well as progesterone, increase the rate of sebum secretion
At puberty, the increase in sebaceous lipids appears to promote a “friendly environment” for more persistent colonization by Malassezia spp
+Individual Sensitivity
Oleic acid dose data physiologically relevant concentration wasable to induce a flaking response which was indistinguishablefrom dandruff in dandruff susceptible patients but not in non-
susceptible patients
This finding provides evidence for a direct role of these fatty acid metabolites in dandruff and suggests an underlying difference amongst individuals that predisposes some to the development of dandruff or
seborrheic dermatitis.
innate differences in stratum corneum barrier function, skin permeability, and immune response to free fatty acids or
proteins and polysaccharides from Malassezia
+
OA induces dandruff-like desquamation in dandruff subjects. The two doses were statistically
significant (po0.1) at days 5, 7, and 8. The effect was not related to growth induction of Malassezia, as their population was monitored throughout the
study and there was no significant population change.
+
Dandruff-like flaking induced by oleic acid in subjects previously identified as dandruff susceptible. Flaking was significantly in- creased on days 5, 7, and 8, in the absence of Malassezia.
+
OA, at the same dose, does not induce flaking in non- dandruff subjects,
subjects pre-determined to not suffer from
dandruff do not have increased flaking when
challenged with an equivalent dose of OA.
+
Dandruff-like flaking induced by oleic acid in subjects previously identified as not dandruff susceptible. Flaking was not significantly increased by application of oleic acid.
+ Drag picture to placeholder or click icon to add
Drag picture to placeholder or click icon to addDiscussio
n
+
Penderita dermatitis seboroik biasanya mempunyai kulit kaya sebum dan
berminyak.Lipid sebum penting untuk proliferasi Malassezia dan sintesa faktor-faktor proinflamasi sehingga menciptakan
kondisi yang sesuai untuk perkembangan dermatitis seboroik.
+ • Dalam laporan ini Malassezia merepresentasikan bahwa metabolit dari asam lemak (OA) mampu menginduksi pengelupasan kulit kepala pada individu yang rentan, tetapi tidak pada individu non-rentan.
• Kurangnya respon dari individu non-rentan sangat penting, dimana dalam laporan lain menunjukkan adanya gangguan barrier yang signifikan yang merupakan dampak dari dosis OA yang sedikit lebih tinggi dalam transportasi yang sama pada individu rentan.
• Hasil penderita ketombe menampilkan perbedaan mendasar dalam fungsi permeabilitas barrier, relatif terhadap individu non-ketombe, yang membuat mereka lebih rentan terhadap gangguan barrier yang diinduksi oleh asam lemak (fatty-induced barrier disruption)
+
Data baru yang signifikan menunjukkan hubungan yang kausal antara Malassezia dan ketombe:• (1) ketombe dan dermatitis seboroik (D / SD) dapat diobati secara
efektif dengan berbagai jenis bahan, dari garam seng, garam selenium, dan glikol sampai golongan azoles yang sangat spesifik, dengan satu-satunya kesamaan yang diketahui menjadi link fungsional aktivitas mereka adalah anti jamur
• (2) peningkatan D / SD hampir selalu disertai dengan penurunan level banyaknya Malassezia pada kulit kepala. Sedangkan kelimpahan subjek individu dari kulit kepala sel Malassezia tidak berkorelasi dengan kehadiran atau keparahan D / SD, pengurangan mereka, diantara individu yang simptomatik, sangat mendukung perannya.
+
CONCLUSION
Drag picture to placeholder or click icon to add
Drag picture to placeholder or click icon to add
+
Mengintegrasikan semua data yang tersedia, tampak bahwa ketombe dan dermatitis seboroik hasil yang paling mungkin
dari tiga faktor etiologi spesifik:
1-kerentanan Individu;
2- Sekresi sebasea; dan
3-Malassezia fungi.
Kerentanan individu adalah paling mungkin berhubungan dengan fungsi basal dari permeabilitas barrier, fungsi sistem
kekebalan tubuh, dan bahkan mungkin aksi secara menyeluruh dari komunitas mikroba.