Seborrheic Dermatitis in Patients with Parkinson's Disease Correlates with Motor Symptoms.

Risk of Seborrheic Dermatitis is Two Fold Higher in those with Moderate to Severe Motor Symptoms.

The prevalence of seborrheic dermatitis is known to be increased in several neurological diseases including Parkinson’s disease. For example, the prevalence of SD in the general population is around 3-5 % whereas the prevalence of SD in patients with PD has been reported to range from 18.6% to 59%.

Motor and non-Motor Issues in Parkinson’s Disease

There is not a specific single test that allows one to diagnose Parkinson’s Disease. The diagnosis comes from a combination of information obtained from the history and physical examination. Features such are tremor, muscle rigidity, slowed movement (called bradykinesia), poor balance, speech changes, changes in writing, altered automatic functions (like blinking, smiling and swinging the arms) will help the neurologist properly diagnose Parkinson’s disease

Symptoms of Parkinson’s can be divided into many groups including motor and non motor symptoms and mood changes. Patients affected with Parkinson’s disease (PD) present with numerous motor and nonmotor symptoms. Motor symptoms of Parkinson’s relate the muscle type symptoms and include tremor, rigidity, slowness of movement, falls and dizziness, freezing, muscle cramps and dystonia. Non-motor symptoms include pain, fatigue, low blood pressure, restless legs, bladder and bowel problems, skin and sweating problems, issues with sleep, issues with eating, swallowing, saliva and dental health, issues with speech and communication, eye and foot care.

New study Evaluates Relationship Between SD and Non Motor and Motor Symptoms

Authors of a new study set out to determine how motor and nonmotor symptoms as well as other factors like age, sex and medication use influence the appearance and severity of SD in PD patients.

Results.

The authors used a variety of standardized rating scales to evaluate motor and non symptoms and a dermatologist evaluated seborrheic dermatitis severity.

There were 61 patients in the study. This included 39 (63.0%) males and 22 (36.1%) females. SD was present in 36.1% of the PD patients.

The authors found positive correlations between age, motor-symptoms severity, and SD.

Eleven (50%) patients with moderate-to-severe motor symptoms developed SD, compared with 11 (28.2%) of those with mild motor symptoms

After adjusting for age, disease duration, and sex, there remained a positive correlation between the severity of motor symptoms and SD. Overall, patients with moderate-to-severe motor symptoms had more-severe SD symptoms. The risk of developing SD was 1.8-fold higher in those with moderate to severe motor symptoms compare to those with less severe symptoms.

In this study, there was no correlation between SD and autonomic dysfunction, sleep disturbances, or other nonmotor symptoms, and no sex difference.

Does SD influence the development of motor symptoms or do motor symptoms influence the develoment of SD?

The authors also evaluated whether the diagnosis of SD prior to a Parkinson’s disease diagnosis could influence the clinical presentation. One-third of patients in this study (32.8%) reported having symptoms of SD prior to being diagnosed with PD. However, the authors did not find that prior SD influenced to the severity of motor symptoms, the appearance or severity of non-motor symptoms. The authors felt this supported their overall theory that that motor symptoms are more closely linked to the eventual development of SD and not vice versa.

The authors found that patients with moderate-to-severe motor symptoms had more-severe SD symptoms.

Conclusion

Overall, this study showed a number of key findings

a) one third of patients with PD had SD.

b) After adjusting for age, disease duration, and sex, the authors found a positive correlation between motor-symptoms severity and SD. There is a 1.8-fold higher risk of developing SD in those with moderate-to-severe motor symptoms than in those with mild symptoms.

c) Patients with moderate-to-severe motor symptoms have more-severe SD symptoms.

d) Finally, the authors no correlation between SD and autonomic dysfunction, sleep disturbances, or other nonmo- tor symptoms

Reference

Tomic S et al. Seborrheic Dermatitis Is Related to Motor Symptoms in Parkinson's Disease.J Clin Neurol. 2022 Nov;18(6):628-634.

5. Fischer M, Gemende I, Marsch WC, Fischer PA. Skin function and skin disorders in Parkinson’s disease. J Neural Transm (Vienna) 2001;

108:205-213.