Study of Hypersensitivity to <i>Malassezia furfur</i> in Patients with Atopic Dermatitis with Head and Neck Pattern: Is It Useful as a Biomarker and Therapeutic Indicator in These Patients?
Atopic dermatitis (AD) is one of the most prevalent chronic inflammatory diseases. Head and neck (H&N) involvement, also known as the picture-frame pattern, can be a diagnostic and even therapeutic challenge. Sensitization to the fungus <i>Malassezia furfur</i> seems to be implicated...
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| Format: | Article |
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MDPI AG
2022-02-01
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| Series: | Life |
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| Online Access: | https://www.mdpi.com/2075-1729/12/2/299 |
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| author | Francisco José Navarro-Triviño Ángela Ayén-Rodríguez |
| author_facet | Francisco José Navarro-Triviño Ángela Ayén-Rodríguez |
| author_sort | Francisco José Navarro-Triviño |
| collection | DOAJ |
| description | Atopic dermatitis (AD) is one of the most prevalent chronic inflammatory diseases. Head and neck (H&N) involvement, also known as the picture-frame pattern, can be a diagnostic and even therapeutic challenge. Sensitization to the fungus <i>Malassezia furfur</i> seems to be implicated in this clinical presentation. To investigate the role of <i>Malassezia furfur</i> in H&N dermatitis, we performed an observational single-centre study. Serum-specific IgE levels for <i>Malassezia furfur</i> were determined in a total of 25 patients with AD (15 receiving dupilumab treatment, 10 not receiving dupilumab), 14 patients with seborrheic dermatitis, and 19 healthy controls. Reactivity to <i>Malassezia</i><i>furfur</i>, in terms of serum-specific IgE levels (>0.35 Ku.arb./L), was found in 80% of patients with AD. Risk factors to consider include high total IgE levels, sensitization to multiple pneumoallergens, and elevated LDH and CRP levels. Prescription of topical antifungals, oral antifungals, or a combination of both showed good response in 100% of cases in the H&N AD group treated with dupilumab. The most appropriate treatment seems to be the use of oral itraconazole and/or ketoconazole cream. The median treatment time was 3 weeks. Localized dermatitis in H&N significantly affects the patient’s life. We present a study of sensitization to <i>Malassezia furfur</i> in patients with H&N AD. It is important to know the differential diagnosis and to approach the study correctly. Sensitization to <i>Malassezia furfur</i> may be one of the main reasons, especially in patients being treated with dupilumab. The use of antifungals allows for adequate control, avoiding treatment changes and improving the patient’s quality of life. |
| first_indexed | 2024-03-09T21:34:29Z |
| format | Article |
| id | doaj.art-98dfb62df7144ee8847ef5625b3fc6b5 |
| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-09T21:34:29Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-98dfb62df7144ee8847ef5625b3fc6b52023-11-23T20:47:10ZengMDPI AGLife2075-17292022-02-0112229910.3390/life12020299Study of Hypersensitivity to <i>Malassezia furfur</i> in Patients with Atopic Dermatitis with Head and Neck Pattern: Is It Useful as a Biomarker and Therapeutic Indicator in These Patients?Francisco José Navarro-Triviño0Ángela Ayén-Rodríguez1Department of Contact Eczema and Immunoallergic Diseases, Dermatology, Hospital Universitario San Cecilio, Avenida de la Investigación s/n, 18016 Granada, SpainDepartment of Contact Eczema and Immunoallergic Diseases, Dermatology, Hospital Universitario San Cecilio, Avenida de la Investigación s/n, 18016 Granada, SpainAtopic dermatitis (AD) is one of the most prevalent chronic inflammatory diseases. Head and neck (H&N) involvement, also known as the picture-frame pattern, can be a diagnostic and even therapeutic challenge. Sensitization to the fungus <i>Malassezia furfur</i> seems to be implicated in this clinical presentation. To investigate the role of <i>Malassezia furfur</i> in H&N dermatitis, we performed an observational single-centre study. Serum-specific IgE levels for <i>Malassezia furfur</i> were determined in a total of 25 patients with AD (15 receiving dupilumab treatment, 10 not receiving dupilumab), 14 patients with seborrheic dermatitis, and 19 healthy controls. Reactivity to <i>Malassezia</i><i>furfur</i>, in terms of serum-specific IgE levels (>0.35 Ku.arb./L), was found in 80% of patients with AD. Risk factors to consider include high total IgE levels, sensitization to multiple pneumoallergens, and elevated LDH and CRP levels. Prescription of topical antifungals, oral antifungals, or a combination of both showed good response in 100% of cases in the H&N AD group treated with dupilumab. The most appropriate treatment seems to be the use of oral itraconazole and/or ketoconazole cream. The median treatment time was 3 weeks. Localized dermatitis in H&N significantly affects the patient’s life. We present a study of sensitization to <i>Malassezia furfur</i> in patients with H&N AD. It is important to know the differential diagnosis and to approach the study correctly. Sensitization to <i>Malassezia furfur</i> may be one of the main reasons, especially in patients being treated with dupilumab. The use of antifungals allows for adequate control, avoiding treatment changes and improving the patient’s quality of life.https://www.mdpi.com/2075-1729/12/2/299atopic dermatitisdupilumab<i>Malassezia furfur</i>immunoglobulin Eitraconazolehead and neck pattern |
| spellingShingle | Francisco José Navarro-Triviño Ángela Ayén-Rodríguez Study of Hypersensitivity to <i>Malassezia furfur</i> in Patients with Atopic Dermatitis with Head and Neck Pattern: Is It Useful as a Biomarker and Therapeutic Indicator in These Patients? Life atopic dermatitis dupilumab <i>Malassezia furfur</i> immunoglobulin E itraconazole head and neck pattern |
| title | Study of Hypersensitivity to <i>Malassezia furfur</i> in Patients with Atopic Dermatitis with Head and Neck Pattern: Is It Useful as a Biomarker and Therapeutic Indicator in These Patients? |
| title_full | Study of Hypersensitivity to <i>Malassezia furfur</i> in Patients with Atopic Dermatitis with Head and Neck Pattern: Is It Useful as a Biomarker and Therapeutic Indicator in These Patients? |
| title_fullStr | Study of Hypersensitivity to <i>Malassezia furfur</i> in Patients with Atopic Dermatitis with Head and Neck Pattern: Is It Useful as a Biomarker and Therapeutic Indicator in These Patients? |
| title_full_unstemmed | Study of Hypersensitivity to <i>Malassezia furfur</i> in Patients with Atopic Dermatitis with Head and Neck Pattern: Is It Useful as a Biomarker and Therapeutic Indicator in These Patients? |
| title_short | Study of Hypersensitivity to <i>Malassezia furfur</i> in Patients with Atopic Dermatitis with Head and Neck Pattern: Is It Useful as a Biomarker and Therapeutic Indicator in These Patients? |
| title_sort | study of hypersensitivity to i malassezia furfur i in patients with atopic dermatitis with head and neck pattern is it useful as a biomarker and therapeutic indicator in these patients |
| topic | atopic dermatitis dupilumab <i>Malassezia furfur</i> immunoglobulin E itraconazole head and neck pattern |
| url | https://www.mdpi.com/2075-1729/12/2/299 |
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