Correlations between the severity of oily skin and the emotional impact of oily skin with anthropo-somatotypological parameters of men and women with seborrheic dermatitis

The increase in the prevalence and age of seborrhea, its significant impact on the psycho-emotional sphere, social status and social adaptation of patients determines the relevance of further study of the causes of dermatosis in the key of constitutional psychodermatology, namely the study of relationships between oily skin and emotional impact of oily skin with anthropometric indicators. The aim of the study was to analyze the correlations between Oily Skin Self Assessment Scale (OSSAS) and Oily Skin Impact Scale (OSIS) in men and women with seborrheic dermatitis with body structure and size indicators. A survey of 40 men and 40 young women with generalized fatty seborrheic dermatitis done. The OSSAS and OSIS scoring system was used to assess the severity of oily skin and the emotional impact of oily skin in seborrheic dermatitis. Anthropometric survey was carried out according to the scheme of Bunak V. V. (1941). The mathematical scheme of Carter J. and Heath B. (1990) was used to evaluate the somatotype. Matiegka J. (1921) formulas were used to calculate body weight components. In addition, the muscle component of body weight was assessed by the American Nutrition Institute. Correlation analysis was performed in the license package "Statistica 6.0" using the non-parametric Spearman's method. As a result of the conducted researches multiple reliable and moderate unreliable correlations of OSSAS or OSIS with anthropo-somatotypological indicators of men and women of patients with generalized fatty form of seborrheic dermatitis of mild and severe course were established. The practical lack of similar correlations between OSIS and anthroposomatotypological parameters in men and women with severe seborrheic dermatitis is noteworthy. Quantitative analysis of reliable and moderate unreliable correlations of OSSAS or OSIS with anthropo-somatotypological parameters in men and women with seborrheic dermatitis of mild and severe course showed that the vast majority of such correlations are inverse, and unreliable average correlations are often observed (except for OSSAS correlations with anthropo-somatotypological parameters in women with mild disease). It was also found that regardless of sex, most of the reliable or moderately unreliable correlations between OSSAS or OSIS and anthropo-somatotypological indicators are observed in the mild course of the disease. The obtained results of the correlation analysis expand the current understanding of the risk criteria and unfavorable prognosis of seborrheic dermatitis.


Introduction
The activity of the sebaceous glands depends on many components and the amount of sebum can change throughout life. Oily skin is most common in young people during puberty, but is often associated with the constitutional type. Hypertensives are more likely to have thick and oily skin. It is thick, covered with large pores filled with sebaceous glands, comedones, prone to acne, has a greasy sheen, often gray. The test for fat in the central and lateral parts of the face is positive [17].
for humans, but causes some discomfort -both physiological and psychological [8]. In comparison with healthy individuals with high oiliness of the skin in patients with seborrhea, there is an increase in the composition of sebum androgens and a decrease in estrogen. W ith seborrhea in the sebum decreases the concentration of linoleic acid, which leads to an increase in skin pH, changes in epithelial permeability, an increase in the number of microorganisms on the skin surface. The main manifestations of the disease -itching, peeling, the appearance of white scales-crusts, redness and swelling of the affected areas [5,7,11]. According to studies by foreign colleagues [6,8], patients with increased oiliness significantly reduce the quality of life, increase the frequency of anxiety and depression, subjective discomfort compared to healthy peers. In our domestic sample, similar indicators of psycho-emotional state due to the degree of oiliness of the skin have not been studied so far. Increasing the prevalence and expansion of the age limits of this pathology, its significant impact on the psycho-emotional sphere, social status and social adaptation of patients determines the urgency of this problem and the need for further study of the causes of seborrhea in the context of constitutional psychodermatology.
The purpose of the study -to analyze the correlations between the severity of oily skin (OSSAS) and the emotional impact of oily skin (OSIS) in men and women with seborrheic dermatitis with indicators of body structure and size. The OSSAS scoring system was used to assess the severity of oily skin in seborrheic dermatitis [1]. The intensity of the main symptoms of oily skin is assessed on a 5-point scale: 1 -not very; 2 -soft; 3 -moderately; 4 -strongly; 5very strong. Final evaluation of indicators: 12-36 pointseasy course; 37-60 points -severe course. The OSIS scoring system was used to assess the severity of the emotional impact of oily skin [1]. The influence of oily skin on the emotional state of the body is assessed on a 5-point scale: 1 -does not bother; 2 -to put it mildly, worries; 3 -moderately disturbing; 4 -much disturbing; 5very disturbing. Final evaluation of indicators: 2-6 pointsmild course; 6-10 points -severe course.

Materials and methods
Anthropometric survey was conducted according to the scheme of Bunak V. V. [3]. The mathematical scheme of Carter J. and Heath B. was used to evaluate the somatotype [4]. J. Matiegka's formulas were used to calculate fat, bone and muscle components of body weight [13]. In addition, the muscle component of body weight was assessed by the method of the American Institute of Nutrition (AIN) [16].
Correlation analysis was performed in the license package "Statistica 6.0" using the non-parametric Spearman's method.

Results
Correlations between the severity of oily skin (OSSAS) or the severity of the emotional impact of oily skin (OSIS) with the structure and size of men and women with seborrheic dermatitis of mild and severe course are shown in tables 1 and 2.   OBK -girth of the hand (cm); OBS -foot circumference (cm); OBGK1 -chest girth on inspiration (cm); OBGK2 -chest girth on exhalation (cm); OBGK3 -chest girth with calm breathing (cm); PSG -transverse mid-chest size (cm); PNG -transverse lower chest size (cm); SGK -anterior-posterior size of the chest (cm); ACR -shoulder width (cm); SPIN -interspinous distance (cm); CRIS -intercristal distance of the pelvis (cm); T ROCHintertrochanteric distance of the pelvis (cm); CONJ -superficial conjugate (cm); GZPL -thickness of skin and fat folds (TSFF) on a back surface of a shoulder (mm); GPPL -TSFF on a front surface of a shoulder (mm); GPR -TSFF on a forearm (mm); GL -TSFF at the lower angle of the scapula (mm); GGR -TSFF on a breast (mm); GG -TSFF on the abdomen (mm); GB -TSFF on the side

Discussion
Possible causes of seborrhea -hereditary predisposition, the influence of external adverse factors, metabolic disorders and neuroendocrine disorders. The disease affects people of different ages and social status [2,18,19].
Anthropological approach in the clinic of skin diseases allows you to correctly and timely diagnose the problem, identify risk groups and build a whole prognostic system for a particular dermatosis [9,10,12,14]. The literature provides data on the constitutional and hereditary nature of the predisposition to seborrhea, which are generalized by polygenic or multifactorial type of inheritance. There is scientific evidence of the influence of constitutional factors on the possible development of dermatosis, including weight, height and body mass index. The composition of sebum in people of different constitutional types differs significantly and varies with varying degrees of pathological condition [15,20]. Despite the fact that in the screening diagnosis of seborrhea the traditional place is occupied by information obtained using dermatological and general clinical methods of examination, no less important in the diagnosis of dermatosis are data that take into account somatotype and its relationship to skin oiliness and emotional state of patient.
The analysis of OSSAS correlations with anthroposomatotypological indicators of men and women with mild and severe seborrheic dermatitis revealed the following multiple reliable and moderate unreliable correlations: in men with a mild course of the disease -moderate reverse (r = from -0.31 to -0.53), mostly unreliable, correlations with more than half of the girth body sizes and as a consequence with the mesomorphic component of the somatotype (r = -0.30) and muscular components of body weight according to Matiegka  A quantitative analysis of reliable and moderate unreliable correlations in men and women with mild to severe seborrheic dermatitis between OSSAS and anthropo-somatotypological indicators revealed the following distribution of correlations: in men with a mild course of the disease -21 correlations out of 58 possible (36.2 %), among which 1.7 % of strong direct reliable, 1.7 % of average force of unreliable, 6.9 % of  The analysis of OSIS correlations with anthroposomatotypological indicators of men and women with mild and severe seborrheic dermatitis revealed the following multiple reliable and moderate unreliable correlations: in men with a mild course of the disease -moderate inverse (r = from -0.30 to -0.56), mostly unreliable, correlations with more than half of the cephalometric parameters, transverse torso size and TSFF, half of the W DE of the extremities and girth sizes and as a consequence with meso-and endomorphic component of somatotype and muscular components of body weight according to Matiegka and AIN; in men with severe disease course -not found; in women with a mild course of the disease -direct (r = from 0.32 to 0.77), mostly moderate, reliable and unreliable correlations with most cephalometric indicators, as well as inverse (r = from -0.31 to -0.62), mostly moderate, reliable and unreliable correlations with almost half of the girth size of the body, most of the transverse dimensions of the torso and a third of the indicators of TSFF; in women with severe disease course -not found. Thus, founded correlations between men and women with seborrheic dermatitis, between OSSAS or OSIS and anthropo-somatotypological indicators, expands the current understanding of risk criteria and unfavorable prognosis of the disease.

Conclusion
1. When analyzing the correlations of OSSAS or OSIS with anthropo-somatotypological indicators of men and women with generalized fatty seborrheic dermatitis of mild and severe course, it was found that the predominant number of reliable or moderate unreliable (observed more often, except for OSSAS correlations with anthroposomatopoietic dermatitis indicators in women with mild disease) correlations are reversible.
2. In the analysis of correlations of OSSAS or OSIS with anthropo-somatotypological indicators of men and women with seborrheic dermatitis of mild and severe course, it was found that regardless of sex, most reliable or moderately unreliable correlations are observed in mild disease.