雄激素性秃发患者对酮康唑洗剂和二硫化硒洗剂过敏风险分析

doi:10.11958/20250019

天津医药 ›› 2025, Vol. 53 ›› Issue (6): 670-672.doi: 10.11958/20250019

• 药物临床观察 • 上一篇

雄激素性秃发患者对酮康唑洗剂和二硫化硒洗剂过敏风险分析

王英¹^,²(), 杨顶权¹^,²^,^△()

1 中日友好医院皮肤科（邮编100029）
2 中日友好医院国家中西医结合医学中心

收稿日期:2025-01-02 修回日期:2025-03-30 出版日期:2025-06-15 发布日期:2025-06-20
通讯作者: ^△E-mail：ydqlx@163.com
作者简介:王英（1987），女，主治医师，主要从事毛发疾病、过敏性疾病、银屑病方面研究。E-mail：dr_wy@hotmail.com

Risk analysis of allergy to ketoconazole shampoo and selenium sulfide shampoo in patients with androgenetic alopecia

WANG Ying¹^,²(), YANG Dingquan¹^,²^,^△()

1 Department of Dermatology, China-Japan Friendship Hospital, Beijing 100029, China
2 National Center for Integrative Medicine, China-Japan Friendship Hospital

Received:2025-01-02 Revised:2025-03-30 Published:2025-06-15 Online:2025-06-20
Contact: ^△E-mail: ydqlx@163.com

王英, 杨顶权. 雄激素性秃发患者对酮康唑洗剂和二硫化硒洗剂过敏风险分析[J]. 天津医药, 2025, 53(6): 670-672.

WANG Ying, YANG Dingquan. Risk analysis of allergy to ketoconazole shampoo and selenium sulfide shampoo in patients with androgenetic alopecia[J]. Tianjin Medical Journal, 2025, 53(6): 670-672.

摘要/Abstract

摘要：

目的分析雄激素性秃发（AGA）患者接触酮康唑洗剂和二硫化硒洗剂的过敏反应发生率。方法对683例AGA患者进行了回顾性分析，依据病历资料、皮肤镜检查、真菌检查及斑贴试验结果，记录伴发脂溢性皮炎患者人数、马拉色菌检测阳性患者人数，及对酮康唑洗剂和二硫化硒洗剂接触过敏人数，分别计算上述指标的发生率或阳性率。结果 AGA患者中脂溢性皮炎发生率为65.59%，马拉色菌阳性率为42.02%。在AGA患者中酮康唑洗剂的过敏率为34.70%，明显高于二硫化硒洗剂的25.62%（P<0.01）。伴发脂溢性皮炎和马拉色菌阳性的AGA患者中，酮康唑洗剂过敏率高于二硫化硒洗剂（P<0.05）。脂溢性皮炎患者中马拉色菌阳性率为45.98%，高于非脂溢性皮炎患者中的34.47%（P<0.01）。结论对于AGA患者，接触酮康唑洗剂相比二硫化硒洗剂具有更高的过敏风险，使用过程中应避免抗真菌洗剂长期使用，必要时采用斑贴试验进行药敏检测。

关键词: 秃发, 皮炎, 脂溢性, 二硫化物类, 硒, 酮康唑, 皮炎, 接触性

Abstract:

Objective To analyze the incidence of contact allergic reactions to ketoconazole shampoo and selenium sulfide shampoo in patients with androgenetic alopecia (AGA). Methods A retrospective analysis was conducted on 683 AGA patients. Based on medical records, dermoscopy findings, fungal examinations and patch test results, the number of patients with seborrheic dermatitis, Malassezia-positive cases and contact allergy to ketoconazole and selenium sulfide shampoos were recorded. Results The incidence of seborrheic dermatitis in AGA patients was 65.59%, and the Malassezia-positive rate was 42.02%. The allergy rate to ketoconazole shampoo in AGA patients was 34.70%, which was significantly higher than the 25.62% allergy rate to selenium sulfide shampoo (P<0.01). In AGA patients with concomitant seborrheic dermatitis and Malassezia positivity, the allergy rate to ketoconazole lotion was higher than that to selenium sulfide lotion (P<0.05). The positivity rate of Malassezia was 45.98% in seborrheic dermatitis patients, which was higher than that of the 34.47% in non-seborrheic dermatitis patients (P<0.01). Conclusion In patients with AGA, ketoconazole shampoo carries a higher allergy risk compared to selenium sulfide shampoo. Long-term use of antifungal shampoos should be avoided in patients with AGA and conduct patch tests for drug detection when necessary.

Key words: alopecia, dermatitis, seborrheic, disulfides, selenium, ketoconazole, dermatitis, contact

中图分类号:

R758.71

图/表 3

图1 AGA患者中脂溢性皮炎及马拉色菌阳性镜下表现（×40）

Fig.1 Microscopic features of Seborrheic dermatitis and Malassezia in AGA patients (×40)

表1 AGA患者二硫化硒洗剂和酮康唑洗剂斑贴试验具体结果（n=683）

Tab.1 Patch test results of selenium sulfide shampoo and ketoconazole shampoo in AGA patients

抗真菌药物	阳性/例			总阳性率/%
抗真菌药物	+	++	+++	总阳性率/%
酮康唑洗剂	222	15	0	34.70
二硫化硒洗剂	163	10	2	25.62
χ²				13.359^＊＊

表2 不同伴发情况抗真菌药物洗剂斑贴试验阳性比例 [例（%）]

Tab.2 Positive proportions of patch tests for antifungal shampoo in different groups

伴发情况	n	酮康唑洗剂阳性	二硫化硒洗剂阳性	χ²
伴发脂溢性皮炎	448	154（34.38）	123（27.46）	5.022^＊
马拉色菌阳性	287	106（36.93）	81（28.22）	4.957^＊
χ²		0.501	0.051

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雄激素性秃发患者对酮康唑洗剂和二硫化硒洗剂过敏风险分析

Risk analysis of allergy to ketoconazole shampoo and selenium sulfide shampoo in patients with androgenetic alopecia

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