TREATMENT OF DANDRUFF AND SEBORRHEIC ERUPTIONS 457 incz (26) did not observe beneficial effects from its use, he suggested the use of pyridoxal, the biologically active form of the vitamin. (The remain- ing member of the B6 group is pyridoxamine.) Since evidence suggests a synergistic relationship between pyridoxine and essential fatty acids, the use of pyridoxine or pyridoxal conjointly with an unsaturated fatty acid is indicated. Since dandruff is benefited by exposure to the sun, possible beneficial effect of topically applied vitamin D is suggested. It is to be noted that despite coverage of the skin by hair in cows increase of vitamin D in milk in summer is attributed to exposure of cows to the sun. As aforementioned, some effective antidandruff medicaments are ger- micidal and fungicidal. A quaternary ammonium compound with these qualifications and without irritant or allergenic action, therefore, may be effective in treatmen t of dandruff. In the direction of enhancing effect of sulfur, consideration should be given to (a) its use in a soluble form, (b) one that penetrates the skin, (c) a form that duplicates its presence in keratin tissue, a protein-bound sulfur. Keratin is peculiar in that it has a high sulfur content, the sulfur being present almost entirely in the form of the amino-acid cystine. No other protein is so high in cystine as the keratin of human hair. It would appear, therefore, that the metabolism of sulfur probably plays an im- portant role in the development and growth of these tissues. COMMENTS--BY FRANZ HERRMANN, M.D. As to Barnett's question whether or not "antimicrobial" agents, such as mercury, sulfur, etc., might in seborrheic conditions produce their thera- peutic effect by a direct action on the disturbed process of keratinization, I wish to point out that a favorable influence of such agents on faulty keratinization is well conceivable. Keratinization physiologically requires the presence of certain metals, e.g., the presence of traces of manganese for arginase activity during the breakdown of epidermal cell-constituents prior to keratin formation or the presence of copper for keratin synthesis. (Very recently, the disturbed keratinization in psoriasis was regarded as due to inadequate arginase activity. A. Szakall) It is quite possible that substances of proved beneficial influence in seborrhea, such as mercury or sulfur, produce this influence by competing with the action of a metallic component of the skin, by capture of sulfhydryl groups or by correcting in some other way deficient or excessive activities underlying the disturbed process of keratinization. Clinical trials with external applications of a small quantity of certain copper compounds might be of interest. REFERENCES (1) Unna, P. G., "Seborrhoeal Eczema•" 7. Cutaneous Genito-Urinary Diseases, 5, 449 (1887).

458 JOURNAL OF THE SOCIETY OF COSMETIC CHEMISTS (2) Sabouraud, R., "Maladies du Cuir Chevelu," Vol. I, Paris, Masson Co. (1902). (3) Malassez, L., "Note sur le champignon de la p•lade," Arch. de physiol. norm. path., 1, 203 (1874). (4) Whitlock, R. A., "Pityrosporum ovale and Some Scaly Conditions of the Scalp," Brit. Med. y., 1,484 (1953). (5) Templeton, H. J., "Study of Dandruff and of Pityrosporon of Malassez," Arch. Dermatol. and Syphilol., 14, 270 (1926). (6) (a) Moore, M., Kile, R. L., Engman, M. F., Jr., and Engman, M. F., "Pityrosporum Ovale (Bottle Bacillus of Unna, Spore of Malassez).' Cultivation and Possible Role in Seborrheic Dermatitis," Arch. Dermatol. and Syphilol., 33, 457 (1926). (b) Moore, M., "Cultivation and Study of Pityrosporum Ovale, the So-Called Bottle Bacillus ofUnna," Ibid, 31,661 (1935). (7) Acton, H. W., and Panja, G., "Seborrheic Dermatitis or Pityriasis Capitis: Lesion Caused by Malassezia Ovale," Indian Med. Gaz., 62, 603 (1927). (8) MacLeod, J. M. H., and Dowling, G. B., "Experimental Study of the Pityrosporon of Malassez: Morphology, Cultivation and Pathogenicity," Brit. •t. Dermatol., 40, 139 (1928). (9) Ota, M., and Huang, P., "Sur les champignons du glare pityrosporum Sabouraud," Ann. parasitol. humaine et compar[e, 11, 49 (1933). (10) Durfee, T., and Cousins, R. F., "Practical Tests of Dandruff Preparations," Standard Remedies, 22, 3 (1936). (11) Bigham, A., "Investigation into the Presence of Yeast-Like Organisms in Scalp Lesions," Brit. y. Dermatol., 49, 74 (1937). (12) Kile, R., and Engman, M. F., "Further Studies of the Relationship of Pityrosporum Ovale to Seborrheic Eczema," Arch. Dermatol. and Syphilol., 37, 616 (1938). (13) MacKee, G. M., Lewis, G. M., Spence, M. J., and Hopper, M. E., "Dandruff and Seborrhea: I. Flora of 'Normal' and Diseased Scalps," •t. Investigative Dermatol., 1, 131 (1938). (14) (a) Benham, R. W., "Cultural Characteristics of Pityrosporum Ovale--A Lypophytic Fungus," Ibid., 2, 187 (1939). (b) Benham, R. W., "Biology of Pityrosporum Ovale" in Nickerson, W. J., "Biology of Pathogenic Fungi," Boston, Chronica Botanica (1947), pp. 63-70. (15) Emmons, C. W., "Isolation and Pathogenicity of Pityrosporum Ovale," Public Health Report, 55, 1306 (1940). (16) Gots, J. S., Thygeson, P., and Warsman, M., "Observations on Pityrosporum Ovale in Seborrheic Blepharitis and Conjunctivitis, Am. y. Ophthalmology, 30, 1485 (1947). (17) Martin-Scott, J., "The Pityrosporum Ovale," Brit. y. Dermatol., 64, 257 (1952). (18) Leone, R., "Presence and Significance of Pityrosporum Ovale in Pityriasis of Scalp in Figured Seborrheic Eczema and in Various Other Squamous Dermatoses," Minerva dermatol., 27, 93, 123, 128 (1952). (19) Rocha, G. L., Silva, C., Lima, A. O., Goto, M., "Experimental Studies on Pityrosporum Ovale: Its Pathogenicity and Antigenic Capacity," y. Investigative Dermatol., 19, 289 (1952). (20) Dowling, G. B., "The Aetiology of Seborrheic Dermatitis," Brit. y. DermatoL, 51, 1 (1939). (21) Bergeim, O., and Combleer, T., "Acidity of the Scalp, Nature and Possible Relation to Seborrhea," Arch. Dermatol. and Syphilol., 56, 448 (1947). (22) Flesch, P., "Hair Loss from Squalene," Proc. Soc. Exp. Biol. Med., 76, 801 (1951). (23) Barber, H. W., "The Influence of the Sex Hormones on the Skin and Pilo-Sebaceous System with a Discussion of the Aetiology of 'Seborrhoeic' Eruptions," in McKenna, R. M. B., "Modern Trends in Dermatology," London, Paul Hoeber, Inc. (1948), p. 106. (23a) Shapiro, I., "Premature Baldness. Preliminary Report on Treatment with Topically Applied Estrogen Lotion," •t. Med. Soc. New •tersey, 50, 17 (1953). (24) Eller, J. J., and Eller, W., "Estrogenic Ointments, Cutaneous Effects of Topical Ap- plications of Natural Estrogens with Report of Three Hundred and Twenty-one Biopsies," Arch. Dermatol. and Syphilol., 59, 499 (1949). (25) Shefton, L., "Experiences in Skin Department of Prisoner of War Camp Hospital in Singapore 1942-1945," Brit. •t. Dermatol., 59, 159 (1947). (26) Lorincx, A. L., "Nutritional Influences," in Rothman, S., "Physiology and Biochemistry of the Skin," Chicago, University of Chicago Press (1954), p. 662. (27) Burr, G. O., and Burr, M. M., "On the Nature and Role of the Fatty Acids Essential in Nutrition," •t. Biol. Chem., 86, 587 (1930). (28) Schreiner, A. W., Rockwell, E., and Vilter, R. W., "Local Defect in the Metabolism of Pyridoxine in Skin of Persons with Seborrheic Dermatitis of the 'Sicca' Type," •t. Investigative Dermatol., 19, 95 (1952).