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Journal Reading

PUTRI SARAH
030.10.225

Three Etiologic Facets of Dandruff

and Seborrheic Dermatitis:
Malassezia Fungi, Sebaceous
Lipids, and Inividual Sensitivity

Journal Reading

Title
: Three Etiologic Facets of Dandruff and Seborrheic
Dermatitis: Malassezia Fungi, Sebaceo
and
Individual Sensitivity

Author
: DeAngelis YM, Gemmer CM, Kaczvinsky JR, Kenneally D
Schwartz JR, Dawson TL Jr

The Procter & Gamble Company, Cincinnati, Ohio, USA

Journal Publisher
: J Investig Dermatol Symp Proc 10:295297, 200
Available 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 Lipids
There 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 was
able to induce a flaking response which was
indistinguishable
from 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

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RESULT

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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

OA, at the
same dose,
does not
induce
flaking in
nondandruff
subjects,
subjects
predetermined
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.

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Discussio
n

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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 nonrentan.
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)

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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 satusatunya 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

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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.

THANK
YOU