Abstract:
Nonscarring scalp folliculitis (NSSF) has been poorly addressed in the literature. Previous studies have focused more on bacterial aetiology. Recent evidence has suggested an inflammatory hypothesis. Data on the role of Malassezia in NSSF are scarce. We retrospectively reviewed the hospital records of 26 NSSF patients diagnosed between September 2021 and October 2022. Malassezia spores were detected cytologically (May-Grünwald-Giemsa stain) in 96% of the patients. Fourteen patients underwent bacterial culture (no growth (4), coagulase-negative staphylococcus (9), and Staphylococcus aureus (1)). In total, 35% of patients had immunosuppression. Antifungal treatment reduced symptoms in 79% of the patients. Four patients received systemic isotretinoin. Recurrence was observed in 35% of patients. This case series suggests Malassezia should be recognized in the pathogenesis of NSSF, which should be confirmed by large-scale studies. Immunosuppression may serve as a predisposing factor in a subset of patients. Although antifungal treatment is efficient in most patients, frequent recurrences necessitate maintenance therapy.
摘要:
非瘢痕性头皮毛囊炎(NSSF)在文献中很少得到解决。以前的研究更多地集中在细菌病因学上。最近的证据提出了一种炎症假说。关于马拉色菌在NSSF中的作用的数据很少。我们回顾性回顾了2021年9月至2022年10月期间诊断的26例NSSF患者的医院记录。在96%的患者中通过细胞学检测到马拉色菌孢子(May-Grünwald-Giemsa染色)。14例患者接受细菌培养(无生长(4),凝固酶阴性葡萄球菌(9),和金黄色葡萄球菌(1))。总的来说,35%的患者有免疫抑制。抗真菌治疗减轻了79%患者的症状。四名患者接受了全身性异维A酸。35%的患者出现复发。该系列病例提示马拉色菌在NSSF的发病机制中应该得到认可,这应该得到大规模研究的证实。免疫抑制可能是一部分患者的诱发因素。尽管抗真菌治疗对大多数患者有效,频繁复发需要维持治疗。