脂溢性皮炎的发病机制及治疗研究进展

doi:10.35541/cjd.20240175

中华皮肤科杂志 ›› 2025, Vol. 58 ›› Issue (1): 89-92.doi: 10.35541/cjd.20240175

• 综述 • 上一篇

脂溢性皮炎的发病机制及治疗研究进展

王迪¹ 张瑞珺^2，3 康玉英¹

¹山西医科大学第三医院，山西白求恩医院（山西医学科学院），同济山西医院皮肤性病科，太原 030032；²山西白求恩医院（山西医学科学院），山西医科大学第三医院，同济山西医院皮肤性病科，太原 030032；³华中科技大学同济医学院附属同济医院皮肤科，武汉 430030

收稿日期:2024-04-02 修回日期:2024-09-23 发布日期:2025-01-03
通讯作者: 康玉英 E-mail:kyuying2349@163.com
基金资助:
山西省应用基础研究计划（201801D121292）；山西省基础研究计划（202303021221196）

Pathogenesis and treatment of seborrheic dermatitis

Wang Di¹, Zhang Ruijun^2,3, Kang Yuying¹

¹Department of Dermatovenereology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China; ²Department of Dermatovenereology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan 030032, China; ³Department of Dermatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

Received:2024-04-02 Revised:2024-09-23 Published:2025-01-03
Contact: Kang Yuying E-mail:kyuying2349@163.com
Supported by:
Applied Basic Research Program of Shanxi Province （201801D121292）; Fundamental Research Program of Shanxi Province （202303021221196）

摘要/Abstract

摘要： 【摘要】脂溢性皮炎是一种慢性、复发性、炎症性皮肤病，其病因与皮肤微生态失调、脂质代谢异常、皮肤屏障功能受损、免疫反应异常以及遗传因素密切相关。近年来许多新的治疗方法如外用磷酸二酯酶4抑制剂、Janus激酶抑制剂、物理治疗和化学剥脱术等为脂溢性皮炎的治疗提供了更多选择。本文综述了脂溢性皮炎在发病机制和治疗方面的最新研究进展。

关键词: 皮炎, 脂溢性, 治疗学, 发病机制, 皮肤微生态

Abstract: 【Abstract】 Seborrheic dermatitis is a chronic, recurrent, and inflammatory skin disease. Its etiology is intricately related to skin microecological imbalance, dysregulated lipid metabolism, impaired skin barrier function, abnormal immune responses, and genetic predispositions. In recent years, several novel therapeutic approaches have emerged, such as topical phosphodiesterase 4 inhibitors, Janus kinase inhibitors, physical interventions, and chemical peeling, providing more options for the treatment of seborrheic dermatitis. This review summarizes the latest research progress in the pathogenesis and treatment of seborrheic dermatitis.

Key words: Dermatitis, seborrheic, Therapeutics, Pathogenesis, Skin microecology

王迪张瑞珺康玉英. 脂溢性皮炎的发病机制及治疗研究进展[J]. 中华皮肤科杂志, 2025,58(1):89-92. doi:10.35541/cjd.20240175

Wang Di, Zhang Ruijun, Kang Yuying. Pathogenesis and treatment of seborrheic dermatitis[J]. Chinese Journal of Dermatology, 2025, 58(1): 89-92.doi:10.35541/cjd.20240175

参考文献 43

［1］	Lin Q, Panchamukhi A, Li P, et al. Malassezia and Staphylococcus dominate scalp microbiome for seborrheic dermatitis［J］. Bioprocess Biosyst Eng, 2021,44（5）:965⁃975. doi: 10.1007/s00449⁃020⁃02333⁃5.
［2］	King A, Tan MG, Kirshen C, et al. Isotretinoin for the management of moderate⁃to⁃severe seborrheic dermatitis: a systematic review［J］. J Am Acad Dermatol. 2023;89（5）:1063⁃1066. doi:10.1016/j.jaad.2023.07.010.
［3］	Gomes TF, Calado R, Matos AL, et al. Contact allergy to antifungals: results of a 12⁃year retrospective study［J］. Contact Dermatitis, 2022,86（6）:539⁃543. doi: 10.1111/cod.14076.
［4］	Vysochanska V, Koval G. Malassezia colonization correlates with the severity of seborrheic dermatitis［J］. Wiad Lek, 2023,76（6）:1371⁃1377. doi: 10.36740/WLek202306107.
［5］	Tao R, Wang R, Wan Z, et al. Ketoconazole 2% cream alters the skin fungal microbiome in seborrhoeic dermatitis: a cohort study［J］. Clin Exp Dermatol, 2022,47（6）:1088⁃1096. doi: 10.1111/ced.15115.
［6］	Li J, Feng Y, Liu C, et al. Presence of Malassezia hyphae is correlated with pathogenesis of seborrheic dermatitis［J］. Microbiol Spectr, 2022,10（1）:e0116921. doi: 10.1128/spectrum. 01169⁃21.
［7］	Sanders M, Nijsten T, Verlouw J, et al. Composition of cutaneous bacterial microbiome in seborrheic dermatitis patients: a cross⁃sectional study［J/OL］. PLoS One, 2021,16（5）:e0251136. doi: 10.1371/journal.pone.0251136.
［8］	Tanaka A, Cho O, Saito C, et al. Comprehensive pyrosequencing analysis of the bacterial microbiota of the skin of patients with seborrheic dermatitis［J］. Microbiol Immunol, 2016,60（8）:521⁃526. doi: 10.1111/1348⁃0421.12398.
［9］	Yu R, Lin Q, Zhai Y, et al. Recombinant human thymosin beta⁃4 （rhTβ4） improved scalp condition and microbiome homeostasis in seborrheic dermatitis［J］. Microb Biotechnol, 2021,14（5）:2152⁃2163. doi: 10.1111/1751⁃7915.13897.
［10］	Loing E, Lamarque E, Borel M. New targets in the battle against dandruff［J］. J Cosmet Sci, 2017,68（1）:107⁃113.
［11］	Suchonwanit P, Triyangkulsri K, Ploydaeng M, et al. Assessing biophysical and physiological profiles of scalp seborrheic dermatitis in the Thai population［J］. Biomed Res Int, 2019,2019:5128376. doi: 10.1155/2019/5128376.
［12］	Ugochukwu I, Rhimi W, Chebil W, et al. Part 2: understanding the role of Malassezia spp. in skin disorders: pathogenesis of Malassezia associated skin infections［J］. Expert Rev Anti Infect Ther, 2023,21（11）:1245⁃1257. doi: 10.1080/14787210.2023. 2274500.
［13］	Rousel J, Nădăban A, Saghari M, et al. Lesional skin of seborrheic dermatitis patients is characterized by skin barrier dysfunction and correlating alterations in the stratum corneum ceramide composition［J］. Exp Dermatol, 2024,33（1）:e14952. doi: 10.1111/exd.14952.
［14］	Tao R, Li R, Wang R. Skin microbiome alterations in seborrheic dermatitis and dandruff: a systematic review［J］. Exp Dermatol, 2021,30（10）:1546⁃1553. doi: 10.1111/exd.14450.
［15］	Mahlangeni GM, Tod BM, Jordaan HF, et al. Clinicopathological features of seborrheic⁃like dermatitis in HIV⁃infected adults: a single institutional descriptive cross⁃sectional study［J］. Am J Dermatopathol, 2021,43（1）:27⁃34. doi: 10.1097/DAD.00000000 00001670.
［16］	Trznadel⁃Grodzka E, Błaszkowski M, Rotsztejn H. Investigations of seborrheic dermatitis. Part I. The role of selected cytokines in the pathogenesis of seborrheic dermatitis［J］. Postepy Hig Med Dosw （Online）, 2012,66:843⁃847. doi: 10.5604/17322693.101 9642.
［17］	Faergemann J, Bergbrant IM, Dohsé M, et al. Seborrhoeic dermatitis and Pityrosporum （Malassezia） folliculitis: characterization of inflammatory cells and mediators in the skin by immunohistochemistry［J］. Br J Dermatol, 2001,144（3）:549⁃556. doi: 10.1046/j.1365⁃2133.2001.04082.x.
［18］	Park HR, Oh JH, Lee YJ, et al. Inflammasome⁃mediated inflammation by Malassezia in human keratinocytes: a comparative analysis with different strains［J］. Mycoses, 2021,64（3）:292⁃299. doi: 10.1111/myc.13214.
［19］	Zouboulis CC. The sebaceous gland［J］. Hautarzt, 2010,61（6）:467⁃468, 4704, 476⁃477. doi: 10.1007/s00105⁃009⁃1894⁃y.
［20］	Ozgul A, Altunisik N, Turkmen D, et al. The relationship between seborrheic dermatitis and body composition parameters［J］. North Clin Istanb, 2023,10（2）:271⁃276. doi: 10.14744/nci. 2022.08068.
［21］	Karakadze MA, Hirt PA, Wikramanayake TC. The genetic basis of seborrhoeic dermatitis: a review［J］. J Eur Acad Dermatol Venereol, 2018,32（4）:529⁃536. doi: 10.1111/jdv.14704.
［22］	Fayad AA, El Gayed EMA, Bazid HAS, et al. Evaluation of the role of ACT1 gene polymorphism in seborrheic dermatitis: a case⁃control study［J］. Menoufia Medical Journal, 2022,35（2）:451⁃457. doi: 10.4103/mmj.mmj_190_21.
［23］	Bentivegna K, Adalsteinsson JA, Chang MW. Oral candidiasis and seborrheic dermatitis in an 8⁃year⁃old female with a heterozygous variant of the IL⁃17RC gene［J］. Pediatr Dermatol, 2023,40（6）:1145⁃1146. doi: 10.1111/pde.15343.
［24］	Kim H, Yun JW, Baek G, et al. Differential microRNA profiles in elderly males with seborrheic dermatitis［J］. Sci Rep, 2022,12（1）:21241. doi: 10.1038/s41598⁃022⁃24383⁃3.
［25］	Tomic S, Kuric I, Kuric TG, et al. Seborrheic dermatitis is related to motor symptoms in Parkinson's disease［J］. J Clin Neurol, 2022,18（6）:628⁃634. doi: 10.3988/jcn.2022.18.6.628.
［26］	Rork JF, McCormack L, Lal K, et al. Dermatologic conditions in Down syndrome: a single⁃center retrospective chart review［J］. Pediatr Dermatol, 2020,37（5）:811⁃816. doi: 10.1111/pde.14214.
［27］	Tosun M, Yasak Güner R, Akyol M. Investigation of the relationship between inflammatory blood parameters and seborrheic dermatitis［J］. J Cosmet Dermatol, 2022,21（10）:5111⁃5115. doi: 10.1111/jocd.14984.
［28］	Jahan I, Islam MR, Islam MR, et al. Altered serum elements, antioxidants, MDA, and immunoglobulins are associated with an increased risk of seborrheic dermatitis［J］. Heliyon, 2021,7（3）:e06621. doi: 10.1016/j.heliyon.2021.e06621.
［29］	Akbaş A, Kılınç F, Şener S, et al. Vitamin D levels in patients with seborrheic dermatitis［J］. Rev Assoc Med Bras （1992）, 2023,69（7）:e20230022. doi: 10.1590/1806⁃9282.20230022.
［30］	Lancar R, Missy P, Dupuy A, et al. Risk factors for seborrhoeic dermatitis flares: case⁃control and case⁃crossover study［J］. Acta Derm Venereol, 2020,100（17）:adv00292. doi: 10.2340/000155 55⁃3661.
［31］	Ozgul A, Altunisik N, Turkmen D, et al. The relationship between seborrheic dermatitis and body composition parameters［J］. North Clin Istanb, 2023,10（2）:271⁃276. doi: 10.14744/nci. 2022.08068.
［32］	Akbulut TO, Suslu H, Atci T. Is the frequency of seborrheic dermatitis related to climate parameters?［J］. Sisli Etfal Hastan Tip Bul, 2022,56（1）:91⁃95. doi: 10.14744/SEMB.2021.67503.
［33］	Blauvelt A, Draelos ZD, Stein Gold L, et al. Roflumilast foam 0.3% for adolescent and adult patients with seborrheic dermatitis: a randomized, double⁃blinded, vehicle⁃controlled, phase 3 trial［J］. J Am Acad Dermatol, 2024,90（5）:986⁃993. doi: 10.1016/j.jaad.2023.12.065.
［34］	Kapoor R, Shome D, Doshi K, et al. A newer approach in the treatment of seborrheic dermatitis with QR678® and QR678 Neo®⁃a prospective pilot study［J］. J Cosmet Dermatol, 2023,22（11）:3078⁃3087. doi: 10.1111/jocd.15957.
［35］	Pope E, Kowalski E, Tausk F. Topical ruxolitinib in the treatment of refractory facial seborrheic dermatitis［J］. JAAD Case Rep, 2022,24:59⁃60. doi: 10.1016/j.jdcr.2022.04.003.
［36］	Tsai WH, Fang YT, Huang TY, et al. Heat⁃killed Lacticaseibacillus paracasei GMNL⁃653 ameliorates human scalp health by regulating scalp microbiome［J］. BMC Microbiol, 2023,23（1）:121. doi: 10.1186/s12866⁃023⁃02870⁃5.
［37］	Raymond O, Abidi Z, Pannu S, et al. 44105 Hydradermabrasion treatment outcomes in a pediatric and adult patient with seborrheic dermatitis［J］. Journal of the American Academy of Dermatology, 2023,89（3）:AB174. doi: 10.1016/j.jaad.2023. 07.696.
［38］	Liu J, Han C, Feng X, et al. Effective picosecond Nd:YAG laser on seborrheic dermatitis and its mechanism［J］. J Cosmet Dermatol, 2022,21（6）:2449⁃2457. doi: 10.1111/jocd.14414.
［39］	Choi YG, Kim SY, Kim JS, et al. Efficacy and safety of precision cryotherapy to treat seborrheic dermatitis of the scalp［J］. Dermatol Surg, 2024,50（1）:47⁃51. doi: 10.1097/DSS.00000000 00003960.
［40］	Fonseka S, Narankotuwa K, Bandara D. Light⁃emitting diode light therapy for facial seborrhoeic dermatitis: a case report［J］. J Cutan Aesthet Surg, 2021,14（2）:241⁃243. doi: 10.4103/JCAS.JCAS_188_20.
［41］	中华医学会皮肤性病学分会, 中国医师协会皮肤科医师分会, 中国中西医结合学会皮肤性病专业委员会. 中国化学剥脱术临床应用专家共识（2022）［J］. 中华皮肤科杂志, 2022,55（11）:949⁃955. doi: 10.35541/cjd.20220309.
［42］	Gu RL, Wang SQ. Clinical study on treatment of facial seborrheic dermatitis with intense pulsed light combined with 30% supramolecular salicylic acid［J］. Clinics （Sao Paulo）, 2020,75:e1875. doi: 10.6061/clinics/2020/e1875.
［43］	邓涵, 张旭冉, 方蕊馨, 等. 复合酸治疗头皮脂溢性皮炎的临床疗效研究［J］. 中国医疗美容, 2023,13（9）:37⁃41. doi: 10. 19593/j.issn.2095⁃0721.2023.09.011.

[1]	李明李妍李邻峰. Janus激酶抑制剂在中重度特应性皮炎中的应用进展[J]. 中华皮肤科杂志, 2025, 58(3): 20220342-e0220342.
[2]	许焯红胡煜顾恒. 间充质干细胞来源的外泌体在皮肤病中的作用[J]. 中华皮肤科杂志, 2025, 58(3): 20220881-e20220881.
[3]	王博郑捷. 老年银屑病和特应性皮炎患者生物制剂及小分子药物治疗中应注意的问题[J]. 中华皮肤科杂志, 2025, 58(1): 72-75.
[4]	杨子靖陈利红阮叶平文莞廷张嘉艺王海伦潘萌赵肖庆. 度普利尤单抗治疗老年性特应性皮炎的疗效及安全性研究[J]. 中华皮肤科杂志, 2025, 58(1): 65-69.
[5]	林子沅庞天怡武静文靳慧. 多环芳烃在炎症性皮肤病发生发展中的作用研究进展[J]. 中华皮肤科杂志, 2024, 57(8): 765-769.
[6]	陈浩天刘莲张婷刘青锋李晓雪刁萍蒋献. 鲜红斑痣发病及进展机制研究进展[J]. 中华皮肤科杂志, 2024, 57(7): 661-664.
[7]	胡清洁徐康朱虹姚煦. 老年特应性皮炎患者使用度普利尤单抗治疗的药物留存率及安全性回顾性队列分析[J]. 中华皮肤科杂志, 2024, 57(7): 632-636.
[8]	蒋献刘莲张婷. 鲜红斑痣的治疗现状及展望[J]. 中华皮肤科杂志, 2024, 57(7): 590-594.
[9]	中华医学会皮肤性病学分会中国康复医学会皮肤性病学分会中国医师协会皮肤科医师分会. [开放获取] 过敏原特异性IgE检测在特应性皮炎中的临床应用专家共识（2024版）[J]. 中华皮肤科杂志, 2024, 57(6): 493-502.
[10]	封梦荻王文氢. 转录因子和受体调控痤疮发病机制的研究进展[J]. 中华皮肤科杂志, 2024, 57(6): 575-578.
[11]	胡梦瑶李敏陈思涵魏雪翠陈宇杰徐松陈旭. 角质形成细胞表达的S100A8/A9在3种常见皮肤炎症损伤模式中调控效应差异的研究[J]. 中华皮肤科杂志, 2024, 57(5): 435-444.
[12]	中国医师协会皮肤科医师分会. [开放获取] 慢性瘙痒管理指南（2024版）[J]. 中华皮肤科杂志, 2024, 57(5): 387-399.
[13]	中国特应性皮炎门诊病历专家共识编写组. [开放获取] 中国特应性皮炎门诊病历模板专家共识（2024）[J]. 中华皮肤科杂志, 2024, 0(5): 20240141-e20240141.
[14]	田静邓思思宋志强. 特应性与非特应性结节性痒疹患者临床特征比较[J]. 中华皮肤科杂志, 2024, 57(4): 331-337.
[15]	严汝帆廖洁月郭子瑜姚南周文玉罗帅寒天张桂英赵明. 天疱疮发病机制和靶向治疗的研究进展[J]. 中华皮肤科杂志, 2024, 57(4): 374-378.

脂溢性皮炎的发病机制及治疗研究进展

Pathogenesis and treatment of seborrheic dermatitis

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献 43

相关文章 15

Metrics

本文评价

推荐阅读 10