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. 2021 Jan;38(1):109-114.
doi: 10.1111/pde.14437. Epub 2020 Nov 6.

Head and neck dermatitis, a subtype of atopic dermatitis induced by Malassezia spp: Clinical aspects and treatment outcomes in adolescent and adult patients

Alba Guglielmo  1 , Andrea Sechi  1 , Annalisa Patrizi  1 , Carlotta Gurioli  1 , Iria Neri  1
Affiliations

Head and neck dermatitis, a subtype of atopic dermatitis induced by Malassezia spp: Clinical aspects and treatment outcomes in adolescent and adult patients

Alba Guglielmo et al. Pediatr Dermatol. 2021 Jan.

Abstract

Background and objectives: Head and neck dermatitis (HND) is a clinical variant of atopic dermatitis (AD), presenting in adolescence or adulthood and characterized by involvement of the head, neck, and superior part of the trunk. The role of Malassezia spp has been advocated in the pathogenesis of HND, and antifungal agents represent the treatment of choice.

Methods: A retrospective single-center study was performed to define the clinical features and treatment response of HND among adolescent and adult patients.

Results: Thirty-one patients were identified, 17 with "adolescent-onset" and 14 with "adult-onset" HND. Adolescent-onset HND positively correlated with a past history of AD and presented with exclusive head and neck involvement (P < .05). Adult-onset HND was associated with concomitant widespread atopic eczema, involving the flexural areas of the upper and lower limbs, trunk, nipples, or hands (P < .05). A positive response to itraconazole in combination with topical treatments was observed in both groups.

Conclusions: This study delineates two HND clinical phenotypes: adolescent vs adult onset. Different characteristics were observed in terms of relationship to AD and eczema localization. A history of AD in childhood and presentation with exclusive involvement of head and neck regions was observed predominantly in the adolescent-onset form, while adult-onset HND often occurred in association with diffuse dermatitis and a past history of AD was less frequent than in the adolescent group. The study is limited by the single-center retrospective nature, which may lead to diagnostic and selection biases, and the small cohort of patients.

Keywords: atopic dermatitis; infection-fungal; pharmacology.

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References

REFERENCES

    1. Bieber T. Atopic dermatitis. N Engl J Med. 2008;358(14):1483-1494.
    1. Baron SE, Cohen SN, Archer CB, British Association of Dermatologists and Royal College of General Practitioners. Guidance on the diagnosis and clinical management of atopic eczema. Clin Exp Dermatol. 2012;37(Suppl 1):7-12.
    1. Katsarou A, Armenaka M. Atopic dermatitis in older patients: particular points. J Eur Acad Dermatol Venereol. 2011;25(1):12-18.
    1. Weidinger S, Novak N. Atopic dermatitis. Lancet. 2016;387(10023):1109-1122.
    1. Silvestre Salvador JF, Romero-Pérez D, Encabo-Duràn B. Atopic dermatitis in adults: a diagnostic challenge. J Investig Allergol Clin Immunol. 2017;27(2):78-88.

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