Efficacy and Safety of Isotretinoin for Moderate-to-Severe Seborrheic Dermatitis: A Systematic Review of Randomized Controlled Trials.

This study provide a comprehensive analysis of using oral isotretinoin as a promising therapy for severe to moderate seborrheic dermatitis, which is a chronic inflammatory skin condition that results in scaling as well as erythema that affects specific sites of the skin such as the scalp, face, upper trunk, or flexures. However, the exact cause of this condition is unclear.Various internal and external factors are associated with its pathogenesis. It is believed that the main factor is the overgrowth of Malassezia yeast, which is a part of the normal skin flora,proliferates in the sebum-rich areas.Other causes include host related factors like genetic predisposition, altered inflammatory responses as well as immune dysregulation, caused by conditions such as HIV or malignancies. In addition, neurophysiological and environmental factors can influence the disease onset. Cold climate, stress, and neurological disorders such as Parkinson's disease all are key factors influencing the onset and relapse of the disease.Pathogenesis involves a complicated interaction between microbial, immunological, and epidermal factors. Malassezia antigens and metabolites in predisposed individuals can trigger both innate and adaptive immunity leading to inflammatory reactions. In addition, Malassezia's lipase activity damages the skin barrier by.producing unsaturated fatty acids, leading to raised epidermal turnover and scaling.