Skin surface electron microscopy in Pityrosporum folliculitis. The role of follicular occlusion in disease and the response to oral ketoconazole.

The yeast Pityrosporum orbiculare is thought to cause the folliculitis associated with seborrheic eczema. However, a combination of mechanical and microbiological factors may be involved, with follicular occlusion leading to yeast overgrowth and folliculitis. Scanning electron microscopy was used to investigate this hypothesis. Skin biopsy specimens obtained from patients with Pityrosporum folliculitis were examined by scanning electron microscopy before and after oral ketoconazole therapy. Patients with active disease showed occlusion of noninflamed follicles, which resolved after ketoconazole treatment. Follicular occlusion was not present in biopsy specimens obtained from unaffected controls nor was it related to the presence of P orbiculare. These findings suggest that follicular occlusion may be a primary event in the development of this folliculitis, with yeast overgrowth a secondary occurrence. The beneficial effect of ketoconazole in this disease may be due to direct effects on the follicle.

Humanity in science: a perspective and a plea.

The phrase "humanity in science" encompasses several problems of various dimensions, which have been present for a long period. Their particular force can be most clearly appreciated by seeing the historical circumstances in which they arose and by examining the changing nature of the social contact between the scientific profession and society. The new ethical imperatives presently operating within society call for new responses. In addition, new ways must be found of mirroring scientific activity so as to more faithfully reflect its real nature to and incorporate it into our culture.