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Biomedical subjects

J Faergemann

Publications and source records attributed to J Faergemann.

At least 55 records · Page 3Linked to original sources
PubMed1993

Pityrosporum ovale and skin diseases.

Pityrosporum ovale is a lipophilic yeast belonging to the normal human cutaneous flora in adults. It is not only a saprophyte but also an opportunistic pathogen associated with: Pityriasis versicolor, Pityrosporum folliculitis, seborrhoeic dermatitis and some forms of atopic dermatitis. Even systemic infections have been described. In pityriasis versicolor P. ovale change from the blastospore to the mycelial form under the influence of predisposing factors such as high temperature, high relative humidity or endogenous factors such as greasy skin, sweating, heredity, immunosuppressive treatment or disorders. Topical treatment is often effective but short term treatment with fluconazole, ketoconazole or itraconazole is also effective. The great problem is recurrence and to avoid this a prophylactic treatment is mandatory. Pityrosporum folliculitis is a chronic disease characterized by pruritic follicular papules and pustules located primarily on the upper trunk, neck and upper arms. Under the influence of the same predisposing factors as in pityriasis versicolor P. ovale increase in numbers in the hair follicles. The main differential diagnosis is acne vulgaris. The effect of antifungal treatment is often dramatic. There are now many studies indicating that P. ovale plays an important role in seborrhoeic dermatitis. Many of these are treatment studies showing a good effect of antimycotics parallelled by a reduction in number of P. ovale. Severe seborrhoeic dermatitis often difficult to treat is associated with AIDS. In a recent study we have evidence for a slight T-cell defect in many patients with seborrhoeic dermatitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Dermatitis, Atopic↗
PubMed1993

Pityriasis versicolor.

The lipophilic yeast Pityrosporum ovale is both a member of the normal human cutaneous flora in adults and the etiological agent of pityriasis versicolor. Pityriasis versicolor develops under the influence of predisposing factors. The presence of these factors are also the reason for the high rate of recurrence seen in pityriasis versicolor and for its chronicity. There are numerous ways of treating pityriasis versicolor topically and systemically. Propylene glycol 50% in water is effective and cheap, but the imidazoles and the older antidandruff shampoos as well as two new antifungals: ciclopiroxolamine and terbinafine are also effective topically. However, short-term oral treatment with ketoconazole, itraconazole or fluconazole are very effective and the risk for side effects minimized with short treatment regiments. The patient compliance is also higher with oral treatment. The recurrence rate is very high, and to avoid this a prophylactic treatment schedule (eg, ketoconazole) one 200 mg tablet on three consecutive days every month or a single dose of 400 mg every month are effective.

Administration, Cutaneous↗
PubMed1992

Pityrosporum ovale and atopic dermatitis in children and young adults.

Children aged 0-21 years, 60 children with atopic dermatitis (AD), 40 children with rhinoconjunctivitis and or asthma (RA) and 40 children with no atopic history (HC) were studied to evaluate the relationship between skin colonisation with Pityrosporum ovale and the occurrence of specific IgE antibodies to P. ovale. The following studies were done: culture for P. ovale, measurement of IgE antibodies to P. ovale (skin prick test, RAST), Candida albicans, and Cladosporium herbarum (RAST) and IgG antibodies to P. ovale. P. ovale could be cultured with about the same frequency in children and young adults with AD and age-matched children with or without other atopic manifestations. In spite of similar colonisation, IgE antibodies against P. ovale occur only in atopy and more frequently in children with AD than in those with other types of atopic disease.

Adolescent↗
PubMed1992

The in vivo effect of UVB radiation on skin bacteria in patients with atopic dermatitis.

Fourteen patients suffering from atopic dermatitis under treatment with UVB radiation were subjected to aerobic bacterial cultures in order to investigate whether this ultraviolet waveband has any in vivo germicidal effects, and, if so, whether there is a correlation with clinical improvement. Treatments were given 3 times a week for 8 weeks. Bacterial samples were collected before, midway and after the termination of therapy. On the latter two occasions, cultures were performed 30 min and 24 h post-UVB irradiation. The main bacteria found were Staphylococcus epidermidis and S. aureus. S. aureus carriage was found in 12 patients in lesional, dermatitic skin, and in 11 patients in clinically non-lesional skin. UVB radiation was found to have an antimicrobial effect primarily concerning S. aureus. Bacterial counts of this organism in lesional skin were decreased from a mean of 1.3 x 10(3) to 1.2 x 10(1) bacteria per cm2 skin at the 8-week 30-min count (p less than 0.01) and 7.5 x 10(1) at the 8-week 24-h count (p less than 0.05). The treatment yielded a statistically significant clinical improvement.

Adult↗
PubMed1992

Treatment of pityriasis versicolor with a single dose of fluconazole.

Twenty-four patients with extensive or recurrent pityriasis versicolor were treated with a single oral dose of 400 mg of fluconazole. Twenty-three patients returned for follow up. Seventeen or 74%, were free of lesions 3 weeks after treatment and no recurrences were seen 6 weeks after treatment. The majority of the patients found the treatment effective, safe and convenient.

Adult↗
PubMed1991

An immunological study in patients with seborrhoeic dermatitis.

The humoral and cellular immune-status was studied in 30 patients with seborrhoeic dermatitis. Increased frequencies of natural killer cells were found in 46% of patients. Furthermore, subnormal mitogen stimulation responses were demonstrated in 13 patients, whereas two individuals were found to have very high numbers of activated T lymphocytes in peripheral blood. Higher-than-normal total serum IgG and IgA was observed in 14 and 11 patients, respectively. For nine of 12 patients with skin lesions, dermal perivascular cell infiltrates were seen. The majority of the infiltrating cells reacted with anti-CD4 antibodies. HLA-DR-expressing keratinocytes were found in two biopsies. The study suggests that patients with seborrhoeic dermatitis may have depressed T-cell function. This could have a bearing on their susceptibility to the Pityrosporum ovale-associated dermatitis. The very high frequencies of activated T cells observed in the peripheral blood of two otherwise healthy seborrhoeic individuals suggests that intermittent systemic immune activation may occur. Seborrhoeic dermatitis is a common skin disease. It can be diagnosed by its characteristic red to yellow-brown lesions covered with greasy scales distributed in areas with a high number of sebaceous glands, such as the scalp, face and upper trunk. There is an association between seborrhoeic dermatitis and the lipophilic yeast Pityrosporum ovale but its exact aetiological role is not known. The yeast is a member of the normal cutaneous flora but also the aetiological agent of pityriasis versicolor and Pityrosporum folliculitis. P. ovale can activate complement via the direct and alternative pathways. This may play some part in the induction of inflammation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

The evaluation of various methods and antigens for the detection of antibodies against Pityrosporum ovale in patients with seborrhoeic dermatitis.

Sera from 10 patients with seborrhoeic dermatitis and from 10 age-matched healthy individuals were examined for IgG activity against Pityrosporum ovale. The IgG activity was analysed using the following techniques: an enzyme-linked immunosorbent assay (ELISA) against whole P. ovale cells, purified cell-wall carbohydrate or protein extract, an indirect slide-immunofluorescence assay and fluorescence-activated flow cytometry using the whole organism as antigen. The ELISA method using the protein antigen was the only technique that showed a significant difference between patients and controls; a lower antibody response was found in the seborrhoeic dermatitis patients compared to healthy controls.

Adult↗
PubMed1991

Terbinafine levels in serum, stratum corneum, dermis-epidermis (without stratum corneum), hair, sebum and eccrine sweat.

We determined terbinafine levels in serum, stratum corneum, dermis-epidermis (without stratum corneum), hair, sebum and eccrine sweat before, during and after 250 mg doses orally to volunteers once daily. Terbinafine is concentrated rapidly in stratum corneum (up to 9.1 micrograms/g of tissue) primarily by diffusion from the vascular system through the dermisepidermis. It also reaches high concentration in sebum (up to 45.1 micrograms/ml) after several days and continue to concentrate in sebum for up to two days after discontinuation of drug. Hair concentration reach levels of 2.6 micrograms/g of tissue indicating high drug levels in and around the hair follicle. It is not found in sweat. Plasma levels range between 0.1 and 1.0 micrograms/ml. There is a tenfold accumulation of drug in stratum corneum by day 2. Elimination of drug from tissue occurs with a half-life of 4 to 5 days and with the potential for drug levels above fungicidal concentrations for dermatophytes for more than 3 weeks. The tissue pharmacokinetic profile of terbinafine is similar to that of another lipophilic drug, itraconazole, but is very different from ketoconazole and griseofulvin. Higher levels of terbinafine are achieved than of either of the imidazoles and remain longer than griseofulvin.

Adolescent↗
PubMed1990

Immune reactions to Pityrosporum ovale in adult patients with atopic and seborrheic dermatitis.

Pityrosporum ovale is a lipophilic yeast commonly present in the seborrheic areas of the skin of adults. Fifty-five young adult patients with atopic dermatitis, 19 patients with seborrheic dermatitis, and 19 healthy control subjects were examined for immune reactions to P. ovale, including tests for specific IgE antibodies (prick test, histamine release), IgG antibodies and epicutaneous testing. IgE antibodies against P. ovale were found in two thirds of the patients with atopic dermatitis and were more frequent in patients with lesions predominantly in the seborrheic areas. In addition, some atopic patients had positive reactions to epicutaneous tests, which suggest that delayed allergic reactions to P. ovale may also be important. In patients with seborrheic dermatitis, no evidence of immediate or delayed hypersensitivity to P. ovale was found. IgG antibody levels were low in all groups.

Adolescent↗
PubMed1990

Scaly lesions on the feet in children--tinea or eczema?

Fungal cultures were negative in 20 children aged 1 to 14 years with a clinical picture consistent with juvenile plantar dermatosis. During the same period (April 1987 to August 1988) 4 cases of tinea pedis were seen in the same age group. The important difference between juvenile plantar dermatosis (with or without associated atopic disease) and the clinical picture seen in dermatophytic infection is described.

Adolescent↗
PubMed1990

Treatment of seborrhoeic dermatitis of the scalp with ketoconazole shampoo. A double-blind study.

Thirty-six patients with seborrhoeic dermatitis of the scalp and culture positive for Pityrosporum ovale were treated in a double-blind placebo controlled study with ketoconazole shampoo twice weekly for 4 weeks. In the ketoconazole group, 16 of 18 patients (89%) became free of lesions or improved, compared with only 8 of 18 (p less than 0.01) in the placebo group. The patients found the shampoo effective, easy to use and cosmetically attractive.

Adult↗
PubMed1990

The effect of ketoconazole and itraconazole on the filamentous form of Pityrosporum ovale.

The effect of ketoconazole and itraconazole on the filamentous form of Pityrosporum ovale in vitro was studied. In a recently developed model, using human stratum corneum in vitro, P. ovale transformed into the filamentous form in 25-30% of the cells. Ketoconazole and itraconazole in concentrations of 0.01, 0.1 and 1 microgram/ml were incubated together with P. ovale cells on human stratum corneum pieces placed on a lipid-enriched culture medium. Both agents effectively blocked the production of hyphae. From the low concentration onwards, the changes consisted of a diminishing transformation into hyphae. With transmission electron microscopy, the interior of many cells was often in an advanced stage of necrosis. Exposure to 1 microgram/ml itraconazole causes a disorganization of the internal organelles in 83% of the cells. This model for the production of hyphae of P. ovale in vitro proved very valuable in screening the activity of antimycotic agents against the filamentous form of this yeast.

Antifungal Agents↗
PubMed1990

The role of Pityrosporum ovale in seborrheic dermatitis.

This paper discusses the relation between the lipophilic dimorphic yeast Pityrosporum ovale and seborrheic dermatitis. A review of studies concerning the microbiology in seborrheic dermatitis and immune reactions to P ovale are given. In our own studies with quantitative cultures, no significant difference was found in the number of P ovale in patients compared with controls, or between healthy and lesional skin in the patient group. IgG serum antibodies against P ovale cells estimated with indirect immunofluorescence did not show any difference between patients and controls, but a significant difference was found when a P ovale protein extract and ELISA were used. Immunological investigation on serum samples were done on 30 patients with seborrheic dermatitis. Defects were found in their T-cell function. The number of P ovale is of importance in those individuals who are susceptible to seborrheic dermatitis and the development of the disease depends on the way their immune system reacts to the antigens derived from P ovale.

Dermatitis, Seborrheic↗
PubMed1990

The phototoxic inhibitory effect and phototoxic killing effect of micro-organisms.

The toxic and phototoxic growth inhibitory and killing effect of Staphylococcus aureus, S. epidermidis, Escherichia coli, Pseudomonas aeruginosa, Streptococcus pyogenus gr. A, St. viridans, Pityrosporum ovale and Candida albicans were studied. P. ovale and St. viridans were the only micro-organisms with any toxic effect against the other micro-organisms tested. P. ovale inhibited the growth of S. aureus, S. epidermidis, Ps. aeruginosa and E. coli. St. viridans inhibited the growth of S. aureus, S. epidermidis, Ps. aeruginosa, E. coli, St. pyogenus gr. A and P. ovale. This effect was only growth inhibitory and not direct killing. The activity was increased by UVA on S. aureus, S. epidermidis and Ps. aeruginosa but not on E. coli and St. pyogenes gr. A. These effects of P. ovale and St. viridans may be of importance in the defense against infections.

Bacteria↗
PubMed1989

A new model for growth and filament production of Pityrosporum ovale (orbiculare) on human stratum corneum in vitro.

A new model for the production of hyphae in Pityrosporum ovale in vitro is described. P. ovale was cultured on human stratum corneum pieces placed directly on a culture medium. The highest number of hyphae (24%) was seen after 6 d of incubation at 37 degrees C in a microaerophilic environment. There was a variation between the strains tested. This model opened possibilities to study the filamentous form of P. ovale in vitro. The effect of antimycotics and variation in antigens may be investigated and compared to the yeast form.

Humans↗
PubMed1989

Infantile seborrhoeic dermatitis and Pityrosporum ovale.

Twenty children (mean age 9 weeks) with infantile seborrhoeic dermatitis (ISD) were investigated with cultures for bacteria, Pityrosporum ovale and other fungi, and 20 healthy children served as controls. P. ovale and Staphylococcus aureus were the dominant organisms. P. ovale was cultured in 18 of 20 infants with ISD as compared to 4 of 20 controls. S. aureus was cultured in 14 of 20 infants with ISD as compared to 1 of 20 controls. The role of S. aureus in ISD is not known, but it could be a secondary invader as is supposed in atopic dermatitis (AD). Even if P. ovale may be suspected as the aetiological agent of ISD further studies are needed to clarify the exact role of the organism in ISD.

Bacteria↗