Changes in ketoconazole, a fungal microflora of seborrheic dermatitis

 A paper investigating the effect of ketoconazole 2% cream on the formation of seborrheic dermatitis dermatophytological microflora was published.

This prospective cohort study aimed to characterize the cutaneous microbial community of seborrheic dermatitis before and after topical treatment with ketoconazole 2% cream using a high-throughput DNA sequencing method. Thirty patients with facial seborrheic dermatitis and 15 healthy age- and gender-matched controls were enrolled in the study. Skin swabs were taken from the site of seborrheic dermatitis lesions on the cheek at baseline, after ketoconazole treatment, and 2 weeks after treatment. DNA was extracted from skin samples. Bacterial 16SV3V4 rRNA and fungal ITS1-5F regions were sequenced and R3.6.1 was used to analyze the composition of the microbial community.

As a result, a significantly lower bacterial and fungal diversity was confirmed at the lesion site of facial seborrheic dermatitis in comparison with the control. Facial seborrheic dermatitis showed a decrease in the relative abundance of Cutibacterium and an increase in the abundance of Malassezia and Staphylococcus. Disease diversity was positively correlated with the relative abundance of Malassezia, Staphylococcus, and Corynebacterium. Transdermal water evaporation (TEWL) was negatively associated with the relative abundance of Cutibacterium. After ketoconazole treatment, fungal diversity and the relative abundance of Candida and Aspergillus increased significantly at the lesion site, and the relative abundance of Malassezia tended to decrease. These changes were confirmed up to 2 weeks after treatment. Ketoconazole treatment has been shown to reduce skin-resident Malassezia, increase fungal diversity, and restore the skin's microbial flora.

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