Photo Credit: Zay Nyi Nyi
The following is a summary of “Fungal Head and Neck Dermatitis: Current Understanding and Management,” published in the July 2024 issue of Allergy and Immunology by Chong et al.
Head and neck dermatitis (HND) is a form of atopic dermatitis (AD) affecting seborrheic areas, leading to greater quality of life detriments. Fungi, especially Malassezia spp., are implicated in the pathogenesis of HND.
Researchers conducted a retrospective study to explore the role of fungi, particularly Malassezia spp., in the pathogenesis of HND.
They examined the penetration of fungal antigens through the defective AD skin barrier, activating innate and adaptive immune responses via the T helper (Th)17 and Th2 axes. They also evaluated antifungal efficacy in HND through multiple double-blind, placebo-controlled trials.
The results showed that antifungal treatments benefit HND, with oral antifungals being more effective than topical ones. The persistence of symptom relief with sustained use remains unclear, and long-term oral antifungal use may be harmful. Dupilumab-associated HND (DAHND) may also be fungal-mediated, with improvement seen with antifungals and evidence of an overactive immune response to Malassezia in these patients.
Investigators found Janus kinase inhibitors effective in treating HND, including DAHND, with potential side effects. They suggested that demographic and environmental factors influencing the host mycobiome should be considered in future precision-medicine approaches for HND.
Source: link.springer.com/article/10.1007/s12016-024-09000-7
