Seborrheic Dermatitis and Systemic Inflammation

Seborrheic dermatitis, which is one of the most common skin manifestations of HIV, has been reported in 85% to 95% of people positive for HIV vs 3% to 5% of uninfected persons.7 Its etiology remains unknown, but it most commonly manifests when CD4 counts drop to ≤550 cells/µL and worsens with CD4 count declines, making it a useful marker of disease progression.2,7 Risk is also increased in men, individuals with oily skin, and in climates with cold, dry winter air.7 Recurrences are common and stress can trigger a flare-up.8 Seborrheic dermatitis is characterized by itchy reddish or pink patches of skin with concomitant greasy-looking white or yellowish flakes or scales.8 It typically affects the scalp and face, but may also involve the ears, chest, upper back, axillae, and groin.8
The role of systemic inflammation in the etiopathogenesis of seborrheic dermatitis (SD) and the correlation between inflammatory markers and SD severity are assessed.

Seborrheic dermatitis (SD) is associated with markers in the blood showing systemic inflammation, researchers reported in a study published in the Journal of Cosmetic Dermatology.

The investigators aimed to assess the role of systemic inflammation in the etiopathogenesis of SD as well as the correlation between inflammatory markers and SD severity.

The analysis included 47 patients (mean age, 35.72 ± 16.44 years; 51.1% women) who presented to a dermatology outpatient clinic from March 2021 to August 2021. The patients had itching, redness, and scaling in predilection sites, including the face, scalp, and upper chest, and clinical findings compatible with SD. A control group of 45 healthy individuals (mean age, 31.42 ± 14.08 years; 66.7% women) without any systemic or dermatological disease were also included.

The SD area and severity index (SEDASI) were noted in the patients. Smoking and alcohol use and body mass index (BMI) values were recorded in the patient and control groups. Other measurements included complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), and neutrophil/ monocyte ratio (NMR). No significant difference was observed regarding tobacco and alcohol use between the control and patient groups.

Mean age was positively correlated with BMI (P < .001) according to bivariate correlation analysis in the patient group. BMI value was positively correlated with left cheek involvement severity (P = .007) and right cheek involvement severity (P = .005), as well as with WBC (P = .012), neutrophils (NEU) (P = .012), lymphocytes (LYM) (P = .024), ESR (P = .04), and CRP (P < .001).

The difference between the 2 groups in NMR values (9.75 ± 2.87 in patients vs 8.31 ± 3.79 in control individuals) in hemogram was significant (P = .043). The patients had higher values in WBC, NEU, platelets, lymphocytes, monocytes, red cell distribution width–coefficient of variation, LMR, and ESR. Mean platelet volume, plateletcrit, PLR, NLR, and CRP values were higher in control individuals (P > .05).

The number of pack-years of cigarette smoking was positively correlated with NEU (P = .035). A positive correlation was also found between the total SEDASI score and LYM (P = .010) and LMR (P = .020).

The researchers noted that their findings are limited by the small number of participants.

As it was noted that BMI and smoking can “trigger the disease through inflammation,” the study authors stated that “Future studies are needed on the role of inflammation in this disease whose etiopathogenesis is not clear.”


Metin Z, Durmaz K. Clinical study: is seborrheic dermatitis associated with systemic inflammation? J Cosmet Dermatol. Published online December 30, 2021. doi:10.1111/jocd.14719