The Experts below are selected from a list of 1902 Experts worldwide ranked by ideXlab platform
Aditya K. Gupta - One of the best experts on this subject based on the ideXlab platform.
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topical treatment of facial Seborrheic Dermatitis a systematic review
2017Co-Authors: Aditya K. Gupta, Sarah G VersteegAbstract:Facial Seborrheic Dermatitis (SD), a chronic inflammatory skin condition, can impact quality of life, and relapses can be frequent. Three broad categories of agents are used to treat SD: antifungal agents, keratolytics, and corticosteroids. Topical therapies are the first line of defense in treating this condition. Our objective was to critically review the published literature on topical treatments for facial SD. We searched PubMed, Scopus, Clinicaltrials.gov, MEDLINE, Embase, and Cochrane library databases for original clinical studies evaluating topical treatments for SD. We then conducted both a critical analysis of the selected studies by grading the evidence and a qualitative comparison of results among and within studies. A total of 32 studies were eligible for inclusion, encompassing 18 topical treatments for facial SD. Pimecrolimus, the focus of seven of the 32 eligible studies, was the most commonly studied topical treatment. Promiseb®, desonide, mometasone furoate, and pimecrolimus were found to be effective topical treatments for facial SD, as they had the lowest recurrence rate, highest clearance rate, and the lowest severity scores (e.g., erythema, scaling, and pruritus), respectively. Ciclopirox olamine, ketoconazole, lithium (gluconate and succinate), and tacrolimus are also strongly recommended (level A recommendations) topical treatments for facial SD, as they are consistently effective across high-quality trials (randomized controlled trials).
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systematic review of oral treatments for Seborrheic Dermatitis
2014Co-Authors: Aditya K. Gupta, M Richardson, Maryse PaquetAbstract:Seborrheic Dermatitis (SD) is normally treated with topical corticosteroids and antifungals. Oral therapies can be prescribed in severe or unresponsive cases. This review aims to assess the quantity and quality of published reports on oral therapies for SD. MEDLINE and Embase databases and the reference listings of publications were searched for any publication using oral treatment for SD. The quality of the included publications was assessed using a modified 27 item checklist by Downs and Black. Twenty-one publications (randomized controlled trials, open trials and case reports) covering eight oral therapies (itraconazole, terbinafine, fluconazole, ketoconazole, pramiconazole, prednisone, isotretinoin and homeopathic mineral therapy) were identified. Most of the publications investigated oral antifungals and the quality of the evidence was generally low. The clinical efficacy outcome reported varied considerably between the studies, preventing statistical analysis and direct comparison between treatments. However, ketoconazole therapy was associated with more relapses compared with other treatments. Itraconazole dosing regimen for SD was generally 200 mg/day for the first week of the month followed by 200 mg/day for the first 2 days for 2–11 months. Terbinafine was prescribed at 250 mg/day either as a continuous (4–6 weeks) or as an intermittent regimen (12 days per month) for 3 months. Fluconazole has administered daily (50 mg/day for 2 weeks) or weekly (200–300 mg) for 2–4 weeks. Ketoconazole dosing regimen was 200 mg daily for 4 weeks. Finally, a single 200 mg dose of pramiconazole was administered to patients. This review also highlights key areas for consideration when designing future studies.
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a novel foam formulation of ketoconazole 2 for the treatment of Seborrheic Dermatitis on multiple body regions
2007Co-Authors: Boni E Elewski, Aditya K. Gupta, William Abramovits, Steven Kempers, Joel Schlessinger, Ted Rosen, Sabra Abraham, Richard RowellAbstract:Background: A novel topical foam formulation of ketoconazole has been developed for use on the scalp, body, and face. Objective: To evaluate the efficacy and safety of twice-daily treatment with ketoconazole 2% foam for Seborrheic Dermatitis on the scalp, body, and face. Methods: One thousand one hundred sixty-two subjects, aged 12 years or older, with mild to severe Seborrheic Dermatitis were randomized to receive ketoconazole foam (n=427), vehicle foam (n=420), ketoconazole cream (n=210), or vehicle cream (n= 105) twice daily for 4 weeks. The primary endpoint was the proportion of subjects achieving an Investigator's Static Global Assessment score of 0 or 1 at week 4 (treatment success). Results: A significantly greater percentage of subjects achieved treatment success using ketoconazole foam than vehicle foam (56% and 42%, respectively; P<.0001); ketoconazole foam was shown to be equivalent to ketoconazole cream. Ketoconarole foam was well-tolerated with a low incidence of treatment-related adverse events (14%; 59/427). Conclusion: Ketoconazole foam 2% is a safe, effective, and versatile formulation for use on the scalp, body, and face for the treatment of Seborrheic Dermatitis in patients aged 12 years or older.
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ciclopirox 1 shampoo for the treatment of Seborrheic Dermatitis
2006Co-Authors: Aditya K. Gupta, Karyn NicolAbstract:Seborrheic Dermatitis is a chronic superficial fungal infection of the skin, particularly affecting sites rich in sebaceous glands. Although the precise etiology of Seborrheic Dermatitis is uncertain, yeasts of the genus Malassezia are known to play a causative role. Ciclopirox is a broad-spectrum, hydroxypyridone-derived, synthetic antifungal agent, which also has anti-inflammatory properties. Ciclopirox is effective both in vitro and in vivo against Malassezia yeasts, making it a valuable option for the treatment of Seborrheic Dermatitis. Varying frequencies and concentrations of ciclopirox shampoo have been shown to be effective and safe in the treatment of Seborrheic Dermatitis of the scalp.
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Role of Antifungal Agents in the Treatment of Seborrheic Dermatitis
2004Co-Authors: Aditya K. Gupta, Karyn Nicol, Roma BatraAbstract:Seborrheic Dermatitis is a superficial fungal disease of the skin, occurring in areas rich in sebaceous glands. It is thought that an association exists between Malassezia yeasts and Seborrheic Dermatitis. This may, in part, be due to an abnormal or inflammatory immune response to these yeasts. The azoles represent the largest class of antifungals used in the treatment of this disease to date. In addition to their antifungal properties, some azoles, including bifonazole, itraconazole, and ketoconazole, have demonstrated anti-inflammatory activity, which may be beneficial in alleviating symptoms. Other topical antifungal agents, such as the allylamines (terbinafine), benzylamines (butenafine), hydroxypyridones (ciclopirox), and immunomodulators (pimecrolimus and tacrolimus), have also been effective. In addition, recent studies have revealed that tea tree oil ( Melaleuca oil), honey, and cinnamic acid have antifungal activity against Malassezia species, which may be of benefit in the treatment of Seborrheic Dermatitis. In cases where Seborrheic Dermatitis is widespread, the use of an oral therapy, such as ketoconazole, itraconazole, and terbinafine, may be preferred. Essentially, antifungal therapy reduces the number of yeasts on the skin, leading to an improvement in Seborrheic Dermatitis. With a wide availability of preparations, including creams, shampoos, and oral formulations, antifungal agents are safe and effective in the treatment of Seborrheic Dermatitis.
Ediléia Bagatin - One of the best experts on this subject based on the ideXlab platform.
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Cutaneous fungal microbiome: Malassezia yeasts in Seborrheic Dermatitis scalp in a randomized, comparative and therapeutic trial
2017Co-Authors: Cristhine Souza Leão Kamamoto, Karime Marques Hassun, Angela Satie Nishikaku, Olga Fischman Gompertz, Analy Salles De Azevedo Melo, Ediléia BagatinAbstract:Malassezia spp in skin microbiome scalp has been implicated in Seborrheic Dermatitis pathogenesis. Thus, treatment based in antifungal combined to topical keratolitic agents have been indicated as well as oral isotretinoin as it reduces the sebum production, glandular's size and possesses anti-inflammatory properties. This randomized, comparative and therapeutic trial aimed toper form the genotypic identification of Malassezia species before and after low-dose oral isotretinoin or topical antifungal treatments for moderate to severe seborrhea and/or Seborrheic Dermatitis on scalp. Scales and sebum of the scalp were seeded in the middle of modified Dixon and incubated at 32°C. For genotypic identification polymerase chain reaction primers for the ITS and D1/D2 ribossomal DNA were used and followed by samples sequencing. The procedure was conducted before and after therapeutic and randomized intervention for moderate to severe seborrhea/Seborrheic Dermatitis on the scalp, including oral isotretinoin, 10 mg, every other day and anti-Seborrheic shampoo (piroctone olamine), over six months. The M. globosa and M. restricta were the most frequent species isolated on the scalp before and after both treatments. Other non-Malassezia species were also identified. The Malassezia spp. were maintained in the scalp after both treatments that were equally effective for the control of seborrhea/Seborrheic Dermatitis clinical signs.
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Low-dose oral isotretinoin for moderate to severe seborrhea and Seborrheic Dermatitis: a randomized comparative trial
2016Co-Authors: Cristhine Souza Leão Kamamoto, Adriana Sañudo, Karime Marques Hassun, Ediléia BagatinAbstract:Background The efficacy of low-dose oral isotretinoin in the treatment of seborrhea and Seborrheic Dermatitis has been poorly investigated in randomized studies. Objectives This study was designed to determine the efficacy and safety of low-dose oral isotretinoin in the treatment of moderate to severe seborrhea and Seborrheic Dermatitis on the scalp and/or face. Methods A randomized, comparative clinical trial, using two groups, was conducted over 6 months. Patients in Group ISO were treated with isotretinoin 10 mg every other day. In Group X, patients received antiSeborrheic topical treatment. Patient opinion, investigator assessment, scalp pruritus, sebum production, and quality of life (QoL) comprised the efficacy outcomes. Results The intention-to-treat population comprised a total of 45 patients with mean ± standard deviation ages of 28.7 ± 5.8 years in Group ISO and 29.8 ± 6.5 years in Group X. The rate of sebum production significantly decreased in Group ISO. Patient opinion, investigator, and QoL assessments improved in both groups. Conclusions Low-dose oral isotretinoin can be a therapeutic modality for moderate to severe seborrhea and Seborrheic Dermatitis.
Eileen Ingham - One of the best experts on this subject based on the ideXlab platform.
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humoral immunity to malassezia furfur serovars a b and c in patients with pityriasis versicolor Seborrheic Dermatitis and controls
1994Co-Authors: H R Ashbee, K T Holland, W J Cunliffe, A Fruin, Eileen InghamAbstract:This study examined the humoral immune responses to Malassezia furfur serovars A, B and C of 10 patients with pityriasis versicolor, 10 patients with Seborrheic Dermatitis and 20 age- and sex-matched controls. A transferable solid-phase ELISA was used to determine titres of total Igs, IgM, IgA and IgG specific to M. furfur serovars A, B and C. The results demonstrated that patients with Seborrheic Dermatitis had a significantly higher litre of total Igs to serovar A than patients with pityriasis versicolor; and that patients with Seborrheic Dermatitis had a significantly higher litre of IgA to serovar C than patients with pityriasis versicolor. The litres of total Igs for controls and patienls with Seborrheic Dermatitis were significantly lower to serovar B than to serovar C. A modified TSP ELISA was used to determine the titres of the IgG subclasses. Titres of IgG 1,3,4 to serovar B were significantly higher in Seborrheic Dermatitis patients than pityriasis versicolor patients and litres of IgG3, to serovar A were significantly higher in Seborrheic Dermatitis patients than pityriasis versicolor patients. However, despite the differences between the patient groups, none of these results was significantly different to those of controls. Thus, this study did not demonstrate any differences in humoral immunity of patients suffering from Malassezia-associated dermatoses when compared to normal controls. These results may suggest that the humoral immune response to M. furfur is not related to the pathogenesis of Malassezia-associated dermatoses, but simply to the carriage of M. furfur on the skin.
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cell mediated immune responses to malassezia furfur serovars a b and c in patients with pityriasis versicolor Seborrheic Dermatitis and controls
1994Co-Authors: H R Ashbee, Eileen Ingham, K T Holland, W J CunliffeAbstract:It has been postulated that patients with Malassezia furfur-associated dermatoses have a deficient cell-mediated immune response to M. furfur. This study examined the cell-mediated immune responses to M. furfur serovars A, B and C of 10 patients with pityriasis versicolor and 10 age- and sex-matched controls; and 10 patients with Seborrheic Dermatitis and 10 age- and sex-matched controls. The responses to each serovar of M. furfur were assessed using the lymphocyte transformation assay and the leukocyte migration inhibition assay. The lymphocyte transformation responses of the patients with pityriasis versicolor to M. furfur serovars A, B and C (0/10, 6/10 and 5/10 respectively) were not significantly different from those of controls (0/10, 2/10 and 1/10). However, for patients with Seborrheic Dermatitis, significantly more patients' lymphocytes responded to serovars B and C (6/10 and 6/10 respectively) than those of controls (1/10 and 1/10). No patient or control responded to serovar A. In the leukocyte migration inhibition assay, the leukocytes from a greater proportion of patients with pityriasis versicolor (5/7) responded to serovar B than controls (2/10); and the leukocytes from a greater proportion of patients with Seborrheic Dermatitis (4/10) responded to serovar C than controls (0/9). Thus, this data did not indicate the presence of any cell-mediated immune deficiency to M. furfur in patients with pityriasis versicolor or Seborrheic Dermatitis, as measured by the lymphocyte transformation assay or the leukocyte migration inhibition assay. The greater responsiveness of T lymphocytes from patients may indicate that T lymphocytes might be involved in the pathogenesis of these diseases.
W J Cunliffe - One of the best experts on this subject based on the ideXlab platform.
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humoral immunity to malassezia furfur serovars a b and c in patients with pityriasis versicolor Seborrheic Dermatitis and controls
1994Co-Authors: H R Ashbee, K T Holland, W J Cunliffe, A Fruin, Eileen InghamAbstract:This study examined the humoral immune responses to Malassezia furfur serovars A, B and C of 10 patients with pityriasis versicolor, 10 patients with Seborrheic Dermatitis and 20 age- and sex-matched controls. A transferable solid-phase ELISA was used to determine titres of total Igs, IgM, IgA and IgG specific to M. furfur serovars A, B and C. The results demonstrated that patients with Seborrheic Dermatitis had a significantly higher litre of total Igs to serovar A than patients with pityriasis versicolor; and that patients with Seborrheic Dermatitis had a significantly higher litre of IgA to serovar C than patients with pityriasis versicolor. The litres of total Igs for controls and patienls with Seborrheic Dermatitis were significantly lower to serovar B than to serovar C. A modified TSP ELISA was used to determine the titres of the IgG subclasses. Titres of IgG 1,3,4 to serovar B were significantly higher in Seborrheic Dermatitis patients than pityriasis versicolor patients and litres of IgG3, to serovar A were significantly higher in Seborrheic Dermatitis patients than pityriasis versicolor patients. However, despite the differences between the patient groups, none of these results was significantly different to those of controls. Thus, this study did not demonstrate any differences in humoral immunity of patients suffering from Malassezia-associated dermatoses when compared to normal controls. These results may suggest that the humoral immune response to M. furfur is not related to the pathogenesis of Malassezia-associated dermatoses, but simply to the carriage of M. furfur on the skin.
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cell mediated immune responses to malassezia furfur serovars a b and c in patients with pityriasis versicolor Seborrheic Dermatitis and controls
1994Co-Authors: H R Ashbee, Eileen Ingham, K T Holland, W J CunliffeAbstract:It has been postulated that patients with Malassezia furfur-associated dermatoses have a deficient cell-mediated immune response to M. furfur. This study examined the cell-mediated immune responses to M. furfur serovars A, B and C of 10 patients with pityriasis versicolor and 10 age- and sex-matched controls; and 10 patients with Seborrheic Dermatitis and 10 age- and sex-matched controls. The responses to each serovar of M. furfur were assessed using the lymphocyte transformation assay and the leukocyte migration inhibition assay. The lymphocyte transformation responses of the patients with pityriasis versicolor to M. furfur serovars A, B and C (0/10, 6/10 and 5/10 respectively) were not significantly different from those of controls (0/10, 2/10 and 1/10). However, for patients with Seborrheic Dermatitis, significantly more patients' lymphocytes responded to serovars B and C (6/10 and 6/10 respectively) than those of controls (1/10 and 1/10). No patient or control responded to serovar A. In the leukocyte migration inhibition assay, the leukocytes from a greater proportion of patients with pityriasis versicolor (5/7) responded to serovar B than controls (2/10); and the leukocytes from a greater proportion of patients with Seborrheic Dermatitis (4/10) responded to serovar C than controls (0/9). Thus, this data did not indicate the presence of any cell-mediated immune deficiency to M. furfur in patients with pityriasis versicolor or Seborrheic Dermatitis, as measured by the lymphocyte transformation assay or the leukocyte migration inhibition assay. The greater responsiveness of T lymphocytes from patients may indicate that T lymphocytes might be involved in the pathogenesis of these diseases.
H R Ashbee - One of the best experts on this subject based on the ideXlab platform.
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humoral immunity to malassezia furfur serovars a b and c in patients with pityriasis versicolor Seborrheic Dermatitis and controls
1994Co-Authors: H R Ashbee, K T Holland, W J Cunliffe, A Fruin, Eileen InghamAbstract:This study examined the humoral immune responses to Malassezia furfur serovars A, B and C of 10 patients with pityriasis versicolor, 10 patients with Seborrheic Dermatitis and 20 age- and sex-matched controls. A transferable solid-phase ELISA was used to determine titres of total Igs, IgM, IgA and IgG specific to M. furfur serovars A, B and C. The results demonstrated that patients with Seborrheic Dermatitis had a significantly higher litre of total Igs to serovar A than patients with pityriasis versicolor; and that patients with Seborrheic Dermatitis had a significantly higher litre of IgA to serovar C than patients with pityriasis versicolor. The litres of total Igs for controls and patienls with Seborrheic Dermatitis were significantly lower to serovar B than to serovar C. A modified TSP ELISA was used to determine the titres of the IgG subclasses. Titres of IgG 1,3,4 to serovar B were significantly higher in Seborrheic Dermatitis patients than pityriasis versicolor patients and litres of IgG3, to serovar A were significantly higher in Seborrheic Dermatitis patients than pityriasis versicolor patients. However, despite the differences between the patient groups, none of these results was significantly different to those of controls. Thus, this study did not demonstrate any differences in humoral immunity of patients suffering from Malassezia-associated dermatoses when compared to normal controls. These results may suggest that the humoral immune response to M. furfur is not related to the pathogenesis of Malassezia-associated dermatoses, but simply to the carriage of M. furfur on the skin.
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cell mediated immune responses to malassezia furfur serovars a b and c in patients with pityriasis versicolor Seborrheic Dermatitis and controls
1994Co-Authors: H R Ashbee, Eileen Ingham, K T Holland, W J CunliffeAbstract:It has been postulated that patients with Malassezia furfur-associated dermatoses have a deficient cell-mediated immune response to M. furfur. This study examined the cell-mediated immune responses to M. furfur serovars A, B and C of 10 patients with pityriasis versicolor and 10 age- and sex-matched controls; and 10 patients with Seborrheic Dermatitis and 10 age- and sex-matched controls. The responses to each serovar of M. furfur were assessed using the lymphocyte transformation assay and the leukocyte migration inhibition assay. The lymphocyte transformation responses of the patients with pityriasis versicolor to M. furfur serovars A, B and C (0/10, 6/10 and 5/10 respectively) were not significantly different from those of controls (0/10, 2/10 and 1/10). However, for patients with Seborrheic Dermatitis, significantly more patients' lymphocytes responded to serovars B and C (6/10 and 6/10 respectively) than those of controls (1/10 and 1/10). No patient or control responded to serovar A. In the leukocyte migration inhibition assay, the leukocytes from a greater proportion of patients with pityriasis versicolor (5/7) responded to serovar B than controls (2/10); and the leukocytes from a greater proportion of patients with Seborrheic Dermatitis (4/10) responded to serovar C than controls (0/9). Thus, this data did not indicate the presence of any cell-mediated immune deficiency to M. furfur in patients with pityriasis versicolor or Seborrheic Dermatitis, as measured by the lymphocyte transformation assay or the leukocyte migration inhibition assay. The greater responsiveness of T lymphocytes from patients may indicate that T lymphocytes might be involved in the pathogenesis of these diseases.
