Skip to main content

Advertisement

SpringerLink
Log in

More yeast, more problems?: reevaluating the role of Malassezia in seborrheic dermatitis

  • REVIEW
  • Published:
Archives of Dermatological Research Aims and scope Submit manuscript

Abstract

Seborrheic dermatitis (SD) is an inflammatory skin disorder and eczema subtype increasingly recognized to be associated with significant physical, psychosocial, and financial burden. The full spectrum of SD, including dandruff localized to the scalp, is estimated to affect half of the world’s population. Despite such high prevalence, the exact etiopathogenesis of SD remains unclear. Historically, many researchers have theorized a central, causative role of Malassezia spp. based on prior studies including the proliferation of Malassezia yeast on lesional skin of some SD patients and empiric clinical response to antifungal therapy. However, upon closer examination, many of these findings have not been reproducible nor consistent. Emerging data from novel, targeted anti-inflammatory therapeutics, as well as evidence from genome-wide association studies and murine models, should prompt a reevaluation of the popular yeast-centered hypothesis. Here, through focused review of the literature, including laboratory studies, clinical trials, and expert consensus, we examine and synthesize the data arguing for and against a primary role for Malassezia in SD. We propose an expansion of SD pathogenesis and suggest reframing our view of SD to be based primarily on dysregulation of the host immune system and skin epidermal barrier, like other eczemas.

Key points

  1. 1.

    Seborrheic dermatitis is a common inflammatory skin disease with poorly understood pathogenesis.

  2. 2.

    Seborrheic dermatitis is commonly considered to be a disease resulting from Malassezia yeast proliferation, though studies supporting this are limited and inconsistent.

  3. 3.

    Emerging evidence suggests that immune dysregulation and skin barrier function are likely central to SD pathogenesis, with Malassezia functioning as a secondary, associated factor

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

The authors confirm that the data supporting the findings of this study are available within the article.

Abbreviations

SD:

Seborrheic dermatitis

TCI:

Topical calcineurin inhibitors

PDE-4:

Phosphodiesterase-4

cAMP:

Cyclic adenosine monophosphate

IGA:

Investigator’s global assessment

FDA:

Food and Drug Administration

NDA:

New Drug Application

PDUFA:

Prescription Drug User Fee Act

GWAS:

Genome-wide association study

ZNF750:

Zinc finger protein 750

MPZL3:

Myelin protein zero-like 3

Th17:

Type 17T helper cell

References

  1. Borda LJ, Wikramanayake TC (2015) Seborrheic dermatitis and dandruff: a comprehensive review. J Clin Investig Dermatol. https://doi.org/10.13188/2373-1044.1000019

    Article  PubMed  PubMed Central  Google Scholar 

  2. Adalsteinsson JA, Kaushik S, Muzumdar S, Guttman-Yassky E, Ungar J (2020) An update on the microbiology, immunology and genetics of seborrheic dermatitis. Exp Dermatol 29(5):481–489. https://doi.org/10.1111/exd.14091

    Article  PubMed  Google Scholar 

  3. de Avelar Breunig J, Couto MOR (2018) Seborrheic dermatitis. In: Bonamigo RR, Dornelles SIT (eds) Dermatology in public health environments: a comprehensive textbook. Springer International Publishing, pp 429–447. https://doi.org/10.1007/978-3-319-33919-1_20

    Chapter  Google Scholar 

  4. Heath CR, Usatine RP (2021) Seborrheic dermatitis. J Fam Pract 70(9):E3–E4. https://doi.org/10.12788/jfp.0315

    Article  PubMed  Google Scholar 

  5. Ranganathan S, Manuel F (2011) A new postulate on two stages of dandruff: a clinical perspective. Int J Trichology 3(1):3. https://doi.org/10.4103/0974-7753.82117

    Article  PubMed  PubMed Central  Google Scholar 

  6. Bickers DR, Lim HW, Margolis D et al (2006) The burden of skin diseases: 2004. J Am Acad Dermatol 55(3):490–500. https://doi.org/10.1016/j.jaad.2006.05.048

    Article  PubMed  Google Scholar 

  7. Karimkhani C, Dellavalle RP, Coffeng LE et al (2017) Global skin disease morbidity and mortality: an update from the global burden of disease study 2013. JAMA Dermatol 153(5):406–412. https://doi.org/10.1001/jamadermatol.2016.5538

    Article  PubMed  PubMed Central  Google Scholar 

  8. Xue Y, Bao W, Zhou J et al (2022) Global burden, incidence and disability-adjusted life-years for dermatitis: a systematic analysis combined with socioeconomic development status, 1990–2019. Front Cell Infect Microbiol 12:861053. https://doi.org/10.3389/fcimb.2022.861053

    Article  PubMed  PubMed Central  Google Scholar 

  9. Wikramanayake TC, Borda LJ, Miteva M, Paus R (2019) Seborrheic dermatitis—looking beyond Malassezia. Exp Dermatol 28(9):991–1001. https://doi.org/10.1111/exd.14006

    Article  PubMed  Google Scholar 

  10. Gupta AK, Kohli Y, Summerbell RC, Faergemann J (2001) Quantitative culture of Malassezia species from different body sites of individuals with or without dermatoses. Med Mycol 39(3):243–251. https://doi.org/10.1080/mmy.39.3.243.251

    Article  CAS  PubMed  Google Scholar 

  11. Dessinioti C, Katsambas A (2013) Seborrheic dermatitis: etiology, risk factors, and treatments. Clin Dermatol 31(4):343–351. https://doi.org/10.1016/j.clindermatol.2013.01.001

    Article  PubMed  Google Scholar 

  12. Prohic A, Jovovic Sadikovic T, Krupalija-Fazlic M, Kuskunovic-Vlahovljak S (2016) Malassezia species in healthy skin and in dermatological conditions. Int J Dermatol 55(5):494–504. https://doi.org/10.1111/ijd.13116

    Article  PubMed  Google Scholar 

  13. Barac A, Pekmezovic M, Milobratovic D, Otasevic-Tasic S, Radunovic M, Arsic AV (2015) Presence, species distribution, and density of Malassezia yeast in patients with seborrhoeic dermatitis—a community-based case-control study and review of literature. Mycoses 58(2):69–75. https://doi.org/10.1111/myc.12276

    Article  PubMed  Google Scholar 

  14. Park M, Park S, Jung WH (2021) Skin commensal fungus Malassezia and its lipases. J Microbiol Biotechnol 31(5):637–644. https://doi.org/10.4014/jmb.2012.12048

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. DeAngelis YM, Gemmer CM, Kaczvinsky JR, Kenneally DC, Schwartz JR, Dawson TL (2005) Three etiologic facets of dandruff and seborrheic dermatitis: malassezia fungi, sebaceous lipids, and individual sensitivity. J Investig Dermatol Symp Proc 10(3):295–297. https://doi.org/10.1111/j.1087-0024.2005.10119.x

    Article  PubMed  Google Scholar 

  16. Plotkin LI, Mathov I, Squiquera L, Leoni J (1998) Arachidonic acid released from epithelial cells by malassezia furfur phospholipase A2: a potential pathophysiologic mechanism. Mycologia 90(2):163. https://doi.org/10.2307/3761291

    Article  CAS  Google Scholar 

  17. Borda LJ, Perper M, Keri JE (2019) Treatment of seborrheic dermatitis: a comprehensive review. J Dermatol Treat 30(2):158–169. https://doi.org/10.1080/09546634.2018.1473554

    Article  CAS  Google Scholar 

  18. Vijaya Chandra SH, Srinivas R, Dawson TL, Common JE (2021) Cutaneous Malassezia: commensal, pathogen, or protector? Front Cell Infect Microbiol 10:614446. https://doi.org/10.3389/fcimb.2020.614446

    Article  PubMed  PubMed Central  Google Scholar 

  19. NIH Intramural Sequencing Center Comparative Sequencing Program, Findley K, Oh J et al (2013) Topographic diversity of fungal and bacterial communities in human skin. Nature 498(7454):367–370. https://doi.org/10.1038/nature12171

    Article  CAS  Google Scholar 

  20. Ianiri G, LeibundGut-Landmann S, Dawson TL (2022) Malassezia: a commensal, pathogen, and mutualist of human and animal skin. Annu Rev Microbiol 76(1):757–782. https://doi.org/10.1146/annurev-micro-040820-010114

    Article  CAS  PubMed  Google Scholar 

  21. Jang SJ, Lim SH, Ko JH et al (2009) The investigation on the distribution of Malassezia yeasts on the normal Korean skin by 26S rDNA PCR-RFLP. Ann Dermatol 21(1):18. https://doi.org/10.5021/ad.2009.21.1.18

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Sugita T, Suzuki M, Goto S et al (2009) Quantitative analysis of the cutaneous Malassezia microbiota in 770 healthy Japanese by age and gender using a real-time PCR assay. Med Mycol. https://doi.org/10.1080/13693780902977976

    Article  Google Scholar 

  23. Lee YW, Byun HJ, Kim BJ et al (2011) Distribution of Malassezia Species on the scalp in Korean seborrheic dermatitis patients. Ann Dermatol 23(2):156. https://doi.org/10.5021/ad.2011.23.2.156

    Article  PubMed  PubMed Central  Google Scholar 

  24. Tajima M, Sugita T, Nishikawa A, Tsuboi R (2008) Molecular analysis of Malassezia microflora in seborrheic dermatitis patients: comparison with other diseases and healthy subjects. J Invest Dermatol 128(2):345–351. https://doi.org/10.1038/sj.jid.5701017

    Article  CAS  PubMed  Google Scholar 

  25. Soares RC, Camargo-Penna PH, De Moraes VCS et al (2016) Dysbiotic bacterial and fungal communities not restricted to clinically affected skin sites in dandruff. Front Cell Infect Microbiol. https://doi.org/10.3389/fcimb.2016.00157

    Article  PubMed  PubMed Central  Google Scholar 

  26. Oh BH, Lee YW, Choe YB, Ahn KJ (2010) Epidemiologic study of Malassezia yeasts in seborrheic dermatitis patients by the analysis of 26S rDNA PCR-RFLP. Ann Dermatol 22(2):149. https://doi.org/10.5021/ad.2010.22.2.149

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Clavaud C, Jourdain R, Bar-Hen A et al (2013) Dandruff is associated with disequilibrium in the proportion of the major bacterial and fungal populations colonizing the scalp. PLoS ONE 8(3):e58203. https://doi.org/10.1371/journal.pone.0058203

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Bergbrant IM, Faergemann J (1989) Seborrhoeic dermatitis and Pityrosporum ovale: a cultural and immunological study. Acta Derm Venereol 69(4):332–335

    CAS  PubMed  Google Scholar 

  29. Ashbee HR, Ingham E, Holland KT, Cunliffe WJ (1993) The carriage of Malassezia furfur serovars A, B and C in patients with pityriasis versicolor, seborrhoeic dermatitis and controls. Br J Dermatol 129(5):533–540. https://doi.org/10.1111/j.1365-2133.1993.tb00480.x

    Article  CAS  PubMed  Google Scholar 

  30. Bergbrant IM (1991) Seborrhoeic dermatitis and Pityrosporum ovale: cultural, immunological and clinical studies. Acta Derm Venereol Suppl (Stockh) 167:1–36

    CAS  PubMed  Google Scholar 

  31. Ashbee HR, Evans EGV (2002) Immunology of diseases associated with Malassezia species. Clin Microbiol Rev 15(1):21–57. https://doi.org/10.1128/CMR.15.1.21-57.2002

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Munoz-Perez R-P, Camacho C (1998) Dermatological findings correlated with CD4 lymphocyte counts in a prospective 3 year study of 1161 patients with human immunodeficiency virus disease predominantly acquired through intravenous drug abuse. Br J Dermatol 139(1):33–39. https://doi.org/10.1046/j.1365-2133.1998.02310.x

    Article  CAS  PubMed  Google Scholar 

  33. Wikler JR, Nieboer C, Willemze R (1992) Quantitative skin cultures of Pityrosporum yeasts in patients seropositive for the human immunodeficiency virus with and without seborrheic dermatitis. J Am Acad Dermatol 27(1):37–39. https://doi.org/10.1016/0190-9622(92)70153-7

    Article  CAS  PubMed  Google Scholar 

  34. Xu Z, Wang Z, Yuan C et al (2016) Dandruff is associated with the conjoined interactions between host and microorganisms. Sci Rep 6(1):24877. https://doi.org/10.1038/srep24877

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Park T, Kim H, Myeong NR et al (2017) Collapse of human scalp microbiome network in dandruff and seborrhoeic dermatitis. Exp Dermatol 26(9):835–838. https://doi.org/10.1111/exd.13293

    Article  PubMed  Google Scholar 

  36. Lin Q, Panchamukhi A, Li P et al (2021) Malassezia and Staphylococcus dominate scalp microbiome for seborrheic dermatitis. Bioprocess Biosyst Eng 44(5):965–975. https://doi.org/10.1007/s00449-020-02333-5

    Article  CAS  PubMed  Google Scholar 

  37. De Pessemier B, Grine L, Debaere M, Maes A, Paetzold B, Callewaert C (2021) Gut-skin axis: current knowledge of the interrelationship between microbial dysbiosis and skin conditions. Microorganisms 9(2):353. https://doi.org/10.3390/microorganisms9020353

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Kim GK (2009) Seborrheic dermatitis and Malassezia species: how are they related? J Clin Aesthetic Dermatol 2(11):14–17

    Google Scholar 

  39. Zani MB, Soares RC, Arruda ACBB, De Arruda LHF, Paulino LC (2016) Ketoconazole does not decrease fungal amount in patients with seborrhoeic dermatitis. Br J Dermatol 175(2):417–421. https://doi.org/10.1111/bjd.14501

    Article  CAS  PubMed  Google Scholar 

  40. Dall’Oglio F, Nasca MR, Gerbino C, Micali G (2022) An overview of the diagnosis and management of seborrheic dermatitis. Clin Cosmet Investig Dermatol 15:1537–1548. https://doi.org/10.2147/CCID.S284671

    Article  PubMed  PubMed Central  Google Scholar 

  41. Okokon EO, Verbeek JH, Ruotsalainen JH, Ojo OA, Bakhoya VN (2015) Topical antifungals for seborrhoeic dermatitis. Cochrane Database Syst Rev 5:CD008138. https://doi.org/10.1002/14651858.CD008138.pub3

    Article  Google Scholar 

  42. Park M, Cho YJ, Lee YW, Jung WH (2018) Understanding the mechanism of action of the anti-dandruff agent zinc pyrithione against Malassezia restricta. Sci Rep 8(1):12086. https://doi.org/10.1038/s41598-018-30588-2

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Liebel F, Lyte P, Garay M, Babad J, Southall MD (2006) Anti-inflammatory and anti-itch activity of sertaconazole nitrate. Arch Dermatol Res 298(4):191–199. https://doi.org/10.1007/s00403-006-0679-8

    Article  CAS  PubMed  Google Scholar 

  44. Schwartz RA, Janusz CA, Janniger CK (2006) Seborrheic dermatitis: an overview. Am Fam Physician 74(1):125–130

    PubMed  Google Scholar 

  45. Mehta A, Nadkarni N, Patil S, Godse K, Gautam M, Agarwal S (2016) Topical corticosteroids in dermatology. Indian J Dermatol Venereol Leprol 82(4):371. https://doi.org/10.4103/0378-6323.178903

    Article  PubMed  Google Scholar 

  46. Armstrong AW, Read C (2020) Pathophysiology, clinical presentation, and treatment of psoriasis: a review. JAMA 323(19):1945. https://doi.org/10.1001/jama.2020.4006

    Article  CAS  PubMed  Google Scholar 

  47. Das A, Panda S (2018) An evidence based approach of use of topical corticosteroids in dermatology. In: Lahiri K (ed) A treatise on topical corticosteroids in dermatology: use, misuse and abuse. Springer, pp 41–72. https://doi.org/10.1007/978-981-10-4609-4_4

    Chapter  Google Scholar 

  48. Kwatra G, Mukhopadhyay S (2018) Topical corticosteroids: pharmacology. In: Lahiri K (ed) A treatise on topical corticosteroids in dermatology: use, misuse and abuse. Springer, pp 11–22. https://doi.org/10.1007/978-981-10-4609-4_2

    Chapter  Google Scholar 

  49. Cook BA, Warshaw EM (2009) Role of topical calcineurin inhibitors in the treatment of seborrheic dermatitis: a review of pathophysiology, safety, and efficacy. Am J Clin Dermatol 10(2):103–118. https://doi.org/10.2165/00128071-200910020-00003

    Article  PubMed  Google Scholar 

  50. Alsmeirat O, Lakhani S, Egaimi M, Idris O, Elkhalifa M (2022) The efficacy and safety of pimecrolimus in patients with facial seborrheic dermatitis: a systematic review of randomized controlled trials. Cureus. https://doi.org/10.7759/cureus.27622

    Article  PubMed  PubMed Central  Google Scholar 

  51. Kim T, Mun J, Jwa S et al (2013) Proactive treatment of adult facial seborrhoeic dermatitis with 0.1% tacrolimus ointment: randomized, double-blind, vehicle-controlled, multi-centre trial. Acta Derm Venereol 93(5):557–561. https://doi.org/10.2340/00015555-1532

    Article  CAS  PubMed  Google Scholar 

  52. Kim HO, Yang YS, Ko HC et al (2015) Maintenance therapy of facial seborrheic dermatitis with 0.1% tacrolimus ointment. Ann Dermatol 27(5):523–530. https://doi.org/10.5021/ad.2015.27.5.523

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Zirwas MJ, Draelos ZD, Du Bois J et al (2023) Efficacy of roflumilast foam, 0.3%, in patients with seborrheic dermatitis: a double-blind vehicle-controlled phase 2a randomized clinical trial. JAMA Dermatol 159(6):613. https://doi.org/10.1001/jamadermatol.2023.0846

    Article  PubMed  PubMed Central  Google Scholar 

  54. Blauvelt A, Draelos ZD, Stein Gold L, Alonso-Llamazares J, Bhatia N, DuBois J, Forman SB, Gooderham M, Green L, Guenthner ST, Hebert AA, Lain E, Moore AY, Papp KA, Zirwas M, Kato S, Snyder S, Krupa D, Burnett P, Berk DR, Chu DH (2024) Roflumilast foam 0.3% for adolescent and adult patients with seborrheic dermatitis: a randomized, double-blinded, vehicle-controlled, phase 3 trial. J Am Acad Dermatol. https://doi.org/10.1016/j.jaad.2023.12.065

    Article  PubMed  Google Scholar 

  55. Wittmann M, Helliwell PS (2013) Phosphodiesterase 4 inhibition in the treatment of psoriasis, psoriatic arthritis and other chronic inflammatory diseases. Dermatol Ther 3(1):1–15. https://doi.org/10.1007/s13555-013-0023-0

    Article  Google Scholar 

  56. Jackson JM, Alexis A, Zirwas M, Taylor S (2022) Unmet needs for patients with seborrheic dermatitis. J Am Acad Dermatol. https://doi.org/10.1016/j.jaad.2022.12.017

    Article  PubMed  PubMed Central  Google Scholar 

  57. Milakovic M, Gooderham MJ (2021) Phosphodiesterase-4 inhibition in psoriasis. Psoriasis Targets Ther 11:21–29. https://doi.org/10.2147/PTT.S303634

    Article  Google Scholar 

  58. Cohen SR, Gordon SC, Lam AH, Rosmarin D (2020) Recalcitrant seborrheic dermatitis successfully treated with apremilast. J Cutan Med Surg 24(1):90–91. https://doi.org/10.1177/1203475419878162

    Article  PubMed  Google Scholar 

  59. Liu D, Chow P, Strawn S, Rajpara A, Wang T, Aires D (2018) Chronic nasolabial fold seborrheic dermatitis successfully controlled with crisaborole. J Drugs Dermatol JDD 17(5):577–578

    PubMed  Google Scholar 

  60. Turner GA, Hoptroff M, Harding CR (2012) Stratum corneum dysfunction in dandruff. Int J Cosmet Sci 34(4):298–306. https://doi.org/10.1111/j.1468-2494.2012.00723.x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Harding CR, Moore AE, Rogers SJ, Meldrum H, Scott AE, McGlone FP (2002) Dandruff: a condition characterized by decreased levels of intercellular lipids in scalp stratum corneum and impaired barrier function. Arch Dermatol Res 294(5):221–230. https://doi.org/10.1007/s00403-002-0323-1

    Article  CAS  PubMed  Google Scholar 

  62. Warner RR, Schwartz JR, Boissy Y, Dawson TL (2001) Dandruff has an altered stratum corneum ultrastructure that is improved with zinc pyrithione shampoo. J Am Acad Dermatol 45(6):897–903. https://doi.org/10.1067/mjd.2001.117849

    Article  CAS  PubMed  Google Scholar 

  63. Yang G, Seok JK, Kang HC, Cho YY, Lee HS, Lee JY (2020) Skin barrier abnormalities and immune dysfunction in atopic dermatitis. Int J Mol Sci 21(8):2867. https://doi.org/10.3390/ijms21082867

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Birnbaum RY, Zvulunov A, Hallel-Halevy D et al (2006) Seborrhea-like dermatitis with psoriasiform elements caused by a mutation in ZNF750, encoding a putative C2H2 zinc finger protein. Nat Genet 38(7):749–751. https://doi.org/10.1038/ng1813

    Article  CAS  PubMed  Google Scholar 

  65. Cohen I, Birnbaum RY, Leibson K, Taube R, Sivan S, Birk OS (2012) ZNF750 is expressed in differentiated keratinocytes and regulates epidermal late differentiation genes. PLoS ONE 7(8):e42628. https://doi.org/10.1371/journal.pone.0042628

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Wikramanayake TC, Borda LJ, Kirsner RS et al (2017) Loss of MPZL3 function causes seborrhoeic dermatitis-like phenotype in mice. Exp Dermatol 26(8):736–738. https://doi.org/10.1111/exd.13150

    Article  PubMed  Google Scholar 

  67. Czyzyk TA, Andrews JL, Coskun T et al (2013) Genetic ablation of myelin protein zero-like 3 in mice increases energy expenditure, improves glycemic control, and reduces hepatic lipid synthesis. Am J Physiol-Endocrinol Metab 305(2):E282–E292. https://doi.org/10.1152/ajpendo.00228.2013

    Article  CAS  PubMed  Google Scholar 

  68. Leiva AG, Chen AL, Devarajan P et al (2014) Loss of Mpzl3 function causes various skin abnormalities and greatly reduced adipose depots. J Invest Dermatol 134(7):1817–1827. https://doi.org/10.1038/jid.2014.94

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Cao T, Racz P, Szauter KM et al (2007) Mutation in Mpzl3, a gene encoding a predicted the adhesion protein, in the rough coat (rc) mice with severe skin and hair abnormalities. J Invest Dermatol 127(6):1375–1386. https://doi.org/10.1038/sj.jid.5700706

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  70. Wikramanayake TC, Hirt P, Almastadi M et al (2018) Increased IL-17-expressing γδ T cells in seborrhoeic dermatitis-like lesions of the Mpzl3 knockout mice. Exp Dermatol 27(12):1408–1411. https://doi.org/10.1111/exd.13798

    Article  CAS  PubMed  Google Scholar 

  71. Blauvelt A, Chiricozzi A (2018) The immunologic role of IL-17 in psoriasis and psoriatic arthritis pathogenesis. Clin Rev Allergy Immunol 55(3):379–390. https://doi.org/10.1007/s12016-018-8702-3

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Zander N, Sommer R, Schäfer I et al (2019) Epidemiology and dermatological comorbidity of seborrhoeic dermatitis: population-based study in 161 269 employees. Br J Dermatol 181(4):743–748. https://doi.org/10.1111/bjd.17826

    Article  CAS  PubMed  Google Scholar 

  73. Russo F, Rizzo A, Santi F et al (2022) A paradoxical head and neck erythema: an adverse event due to dupilumab in adult patients with atopic dermatitis. Int J Dermatol. https://doi.org/10.1111/ijd.15871

    Article  PubMed  Google Scholar 

  74. Al-Janabi A, Marsland AM (2020) Seborrhoeic dermatitis and sebopsoriasis developing in patients on dupilumab: two case reports. Clin Case Rep 8(8):1458–1460. https://doi.org/10.1002/ccr3.2871

    Article  PubMed  PubMed Central  Google Scholar 

  75. Sanders MGH, Pardo LM, Uitterlinden AG, Smith AM, Ginger RS, Nijsten T (2018) The genetics of seborrheic dermatitis: a candidate gene approach and pilot genome-wide association study. J Invest Dermatol 138(4):991–993. https://doi.org/10.1016/j.jid.2017.11.020

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

RC received funding from NIH grant number K12 HS026385.

Author information

Authors and Affiliations

  1. College of Medicine, University of Illinois Chicago, Chicago, IL, USA

    Christy H. Chang

  2. Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Raj Chovatiya

  3. Chicago Medical School, Rosalind Franklin University, North Chicago, IL, USA

    Raj Chovatiya

  4. Center for Medical Dermatology and Immunology Research, Chicago, IL, USA

    Raj Chovatiya

Authors
  1. Christy H. Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Raj Chovatiya
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

RC had full access to all the data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis. Study concept and design: RC. Acquisition of Data: RC, CHC. Analysis and interpretation of data: RC, CHC. Drafting of the manuscript: RC, CHC. Critical revision of the manuscript for important intellectual content: RC, CHC. Statistical analysis: RC, CHC.

Corresponding author

Correspondence to Raj Chovatiya.

Ethics declarations

Conflict of interests

RC has served as an advisory board member, consultant, and/or investigator for AbbVie, Apogee Therapeutics, Arcutis, Argenx, ASLAN Pharmaceuticals, Beiersdorf, Boehringer Ingelheim, Bristol Myers Squibb, Cara Therapeutics, Dermavant, Eli Lilly and Company, FIDE, Galderma, Genentech, Incyte, Janssen, LEO Pharma, L’Oréal, Nektar Therapeutics, Novan, Inc., Opsidio, Pfizer Inc., Regeneron, RAPT, Sanofi, and UCB. CHC has no conflicts to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chang, C.H., Chovatiya, R. More yeast, more problems?: reevaluating the role of Malassezia in seborrheic dermatitis. Arch Dermatol Res 316, 100 (2024). https://doi.org/10.1007/s00403-024-02830-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00403-024-02830-7

Keywords

Search

Navigation