[en] BACKGROUND: Glucocorticoids can boost some Malassezia-driven dermatoses. However, both antifungals and topical corticosteroids improve lesions of seborrheic dermatitis. OBJECTIVE: To revisit the topical activity of the antifungal ketoconazole and the corticosteroid desonide on Malassezia growth on human stratum corneum. Material and Methods: The computer-assisted corneofungimetry bioassay was used to compare the growth of M. furfur, M. globosa and M. restricta on human stratum corneum coated with olive oil. Four blinded gel formulations were tested. They contained either 2% ketoconazole, 0.05% desonide or a combination of 2% ketoconazole and 0.05% desonide; one gel was unmedicated. Untreated stratum corneum and specimens coated with a 2% ketoconazole cream were used as negative and positive comparators, respectively. A total of 45 samples (15 M. furfur, 15 M. globosa, and 15 M. restricta) were used for each test formulation in this randomized, double-blind study. RESULTS: The 2% ketoconazole gel and cream and the combination of 2% ketoconazole and 0.05% desonide formulation abated similarly and significantly the M. furfur, M. globosa and M. restricta growth. The 3 species were similarly sensitive to these formulations. By contrast, no significant inhibitory effect was yielded by the 0.05% desonide gel and the vehicle. CONCLUSION: The presence of 0.05% desonide does not impair or improve the Malassezia susceptibility to 2% ketoconazole when growing on lipid-enriched human stratum corneum.
Disciplines :
Dermatology
Author, co-author :
Pierard, Claudine ; Centre Hospitalier Universitaire de Liège - CHU > Dermatopathologie
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Piérard GE, Piérard-Franchimont C: Skin immune downregulators: From bench to bedside. Curr Top Pharmacol 2003;7:109-116.
Piérard-Franchimont C, Piérard GE: A double-blind placebo-controlled study of ketoconazole + desonide gel combination in the treatment of facial seborrheic dermatitis. Dermatology 2002;204:344-347.
Rurangirwa A, Piérard-Franchimont C, Piérard GE: Culture of fungi on cyanoacryltae skin surface stripings. A quantitative bioassay for evaluating antifungal drugs. Clin Exp Dermatol 1989;14:425-428.
Piérard GE, Piérard-Franchimont C, Arrese Estrada J: Comparative study of the activity and lingering effect of topical antifungals. Skin Pharmacol 1993;6:208-214.
Arrese JE, Schrooten P, De Doncker P, De Smett H, Cauwenbergh G, Piérard-Franchimont C, Piérard GE: Fungal cultures on cyanoacrylate skin surface strippings as a dose-finding method for topical antifungals. A placebo-controlled study with itraconazole 0.25% and 0.50% cream. J Med Vet Mycol 1995;33: 127-130.
Arrese JE, Fogouang L, Piérard-Franchimont C, Piérard GE: Euclidean and fractal computer-assisted corneofungimetry. A comparison of 2% ketoconazole and 1% terbinafine topical formulations. Dermatology 2002;204:222-227.
Faergemann J, Aly R, Maibach HI: Growth and filament production of Pityrosporum orbiculare and P. ovale on human stratum corneum in vitro. Acta Dermatol Venereol 1983;63: 388-392.
Faergemann J: A new model for growth and filament production of Pityrosporum ovale (orbiculare) on human stratum corneum in vitro. J Invest Dermatol 1989;92:117-119.
Naka W, Hanyaku H, Tajima S, Harada T, Nishikawa T: Application of neutral red staining for evaluation of the viability of dermatophytes and Candida in human skin scales. J Med Vet Mycol 1994;32:31-35.
Watanabe S, Kano R, Sato H, Nakamura Y, Hasegawa A: The effects of Malassezia yeasts on cytokine production by human keratinocytes. J Invest Dermatol 2001;116:769-773.
Porro MN, Passi S, Caprilli F, Mercantini R: Induction of hyphae in cultures of pityrosporum by cholesterol and cholesterol esters. J Invest Dermatol 1977;69:531-534.
Guillot J and Guého E: The diversity of Malassezia yeasts confirmed by rRNA sequence and nuclear DNA comparisons. Antonie Van Leeuwenhoek 1995;67:297-314.
Guého E, Midgley G and Guillot J: The genus Malassezia with description of four new species. Antonie Van Leeuwenhoek 1996;69:337-355.
Guillot J. Guého E, Lesourd M: Identification of Malassezia species: A practical approach. J Mycol Med 1996;6:103-110.
Gupta AK, Kohli Y, Li A, Faergemann J, Summerbell, RC: In vitro susceptibility of the seven Malassezia species to ketoconazole, voriconazole, itraconazole and terbinafine. Br J Dermatol 2000;142:758-765.
Piérard GE, Arrese JE, Piérard-Franchimont C: Itraconazole corneofungimetry bioassay on Malassezia species. Mycoses, in press.
Nakabayashi A, Sei Y, Guillot J: Identification of Malassezia species isolated from patients with seborrhoeic dermatitis, atopic dermatitis, pityriasis versicolor and normal subjects. Med Mycol 2000;38:337-341.
Gemmer CM, DeAngelis YM, Theelen B, Boekhout T, Dawson JT Jr: Fast, noninvasive method for molecular detection and differentiation of Malassezia yeast species on human skin and application of the method to dandruff microbiology. J Clin Microbiol 2002;40:3350-3357.
Van Gerven F, Odds FC: The anti-Malassezia furfur activity in vitro and in experimental dermatitis of six imidazole antifungal agents: Bifonazole, clotrimazole, flutrimazole, ketoconazole, miconazole and sertaconazole. Mycoses 1995;38:389-393.
Schmidt A, Rühl-Hörster B: In vitro susceptibility of Malassezia furfur against azole compounds. Mycoses 1996;39:309-312.
Hammer KA, Carson CF, Riley TV: In vitro activities of ketoconazole, econazole micronazole, and Melaleuca alternifolia (tea tree) oil against Malassezia species. Antimicrob Agents Chemother 2000;44:467-469.
Piérard GE, Piérard-Franchimont C, Van Cutsem J, Rurangirwa A, Hoppenbrouwers ML, Schrooten P: Ketoconazole 2% emulsion in the treatment of seborrheic dermatitis. Int J Dermatol 1991;30:806-809.
Piérard-Franchimont C, Hermanns JF, Degreef H, Piérard GE: From axioms to new insights into dandruff. Dermatology 2000;200: 93-98.
Pari T, Pulimood S, Jacob M, George S, Jeyaseelan L. Thomas K: Randomised double blind controlled trial of 2% ketoconazole cream versus 0.05% clobetasol 17-butyrate cream in seborrhoeic dermatitis. J Eur Acad Dermatol Venereol 1998;10:89-90.
van't Veen AJ, Prevoo RLMA, Velders AJ, Jagtman BA, Van Niel JCG, Stolz E: Betamethasone 17-valerate compared with ketoconazole for topical treatment of seborrhoeic dermatitis of the scalp in adults. Results of a Dutch multicenter study. J Dermatol Treat 1998;9:939-945.
Piérard-Franchimont C, Willemaers V, Fraiture AL Piérard GE: Squamometry in seborrheic dermatitis. Int J Dermatol 1999;38:712-715.
Tengvall Linder M, Johanson C, Zargari A, Bengtsson A, Van der Ploeg I, Jones I, Harfast B, Scheynius: Detection of Pityrosporum orbiculare reactive T cells from skin and blood in atopic dermatits and characterization of their cytokine profiles. Clin Exp Allergy 1996;26: 1286-1297.
Buentke E, Heftier LC, Wilson JL, Wallin RPA, Lofman C, Chambers BJ, Ljunggren HG, Scheynius A: Natural killer and dendritic cell contact in lesional atopic dermatitis skin-Malassezia-influenced cell interaction. J Invest Dermatol 2002;119:850-857.
Nikkels AF, Piérard GE: Framing the future of antifungals in atopic dermatitis. Dermatology 2003;206:398-400.
Back O, Scheynius A, Johansson SGO: Ketoconazole in atopic dermatitis: Therapeutic response is correlated with decrease in serum IgE. Arch Dermatol Res 1995;287:448-451.
Letawe C, Piérard-Franchimont C, Piérard GE: Squamometry in rating the efficacy of topical corticosteroids in atopic dermatitis. Eur J Clin Pharmacol 1996;51:253-258.
Piérard GE, Piérard-Franchimont C: Skin immune downregulators: From bench to bedside. Curr Top Pharmacol 2003;7:109-116.
Piérard-Franchimont C, Piérard GE: A double-blind placebo-controlled study of ketoconazole + desonide gel combination in the treatment of facial seborrheic dermatitis. Dermatology 2002;204:344-347.
Rurangirwa A, Piérard-Franchimont C, Piérard GE: Culture of fungi on cyanoacryltae skin surface stripings. A quantitative bioassay for evaluating antifungal drugs. Clin Exp Dermatol 1989;14:425-428.
Piérard GE, Piérard-Franchimont C, Arrese Estrada J: Comparative study of the activity and lingering effect of topical antifungals. Skin Pharmacol 1993;6:208-214.
Arrese JE, Schrooten P, De Doncker P, De Smett H, Cauwenbergh G, Piérard-Franchimont C, Piérard GE: Fungal cultures on cyanoacrylate skin surface strippings as a dose-finding method for topical antifungals. A placebo-controlled study with itraconazole 0.25% and 0.50% cream. J Med Vet Mycol 1995;33: 127-130.
Arrese JE, Fogouang L, Piérard-Franchimont C, Piérard GE: Euclidean and fractal computer-assisted corneofungimetry. A comparison of 2% ketoconazole and 1% terbinafine topical formulations. Dermatology 2002;204:222-227.
Faergemann J, Aly R, Maibach HI: Growth and filament production of Pityrosporum orbiculare and P. ovale on human stratum corneum in vitro. Acta Dermatol Venereol 1983;63: 388-392.
Faergemann J: A new model for growth and filament production of Pityrosporum ovale (orbiculare) on human stratum corneum in vitro. J Invest Dermatol 1989;92:117-119.
Naka W, Hanyaku H, Tajima S, Harada T, Nishikawa T: Application of neutral red staining for evaluation of the viability of dermatophytes and Candida in human skin scales. J Med Vet Mycol 1994;32:31-35.
Watanabe S, Kano R, Sato H, Nakamura Y, Hasegawa A: The effects of Malassezia yeasts on cytokine production by human keratinocytes. J Invest Dermatol 2001;116:769-773.
Porro MN, Passi S, Caprilli F, Mercantini R: Induction of hyphae in cultures of pityrosporum by cholesterol and cholesterol esters. J Invest Dermatol 1977;69:531-534.
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