Pathogenesis (development of disease)
The exact pathogenesis is unclear.
Dermatosis (skin disease) of early infancy (infantile form) and young to middle adulthood (adolescent and adult forms) is thought to be associated with Malassezia species (formerly known as Pityrosporon ovale/yeast fungi) and with hyperfunction of the sebaceous glands.
The yeasts secrete lipases and phosphatases. This leads to cutaneous inflammation (of the skin) and impairment of the epidermal barrier (permeability barrier of the skin), resulting in dermatitis (skin inflammation) in areas rich in sebaceous glands.
Other causes discussed:
- Microbial influences by staphylococci.
- Disturbance of the lipid metabolism
- Hormonal influences with an increase in sebaceous secretion (sebum) in men.
Etiology (causes)
Biographical causes
- Genetic burden from parents, grandparents.
- Hormonal factors such as androgenic effluvium – alopecia due to increased testosterone serum levels.
Behavioral causes
- Psycho-social situation
- Stress* – may increase symptoms
Causes related to disease
- Depression/exhaustion*
- Immunosuppression (e.g., due to HIV infection).
Environmental pollution – intoxications (poisonings).
- Climatic influences* – sunlight exposure can improve symptoms.
* Trigger factors: In a study of 2,159 patients with seborrheic eczema (> 16 years of age), 96% reported trigger factors: Stress, depression/exhaustion (76%), and seasonal influences (44%).