Treatment of moderate to severe facial seborrheic dermatitis with itraconazole: an open non-comparative study.
BACKGROUND
Seborrheic dermatitis is a common chronic disease. Malassezia yeasts have been implicated in the pathogenesis of this disease. Antifungal agents are known to be effective in the treatment of Malassezia yeast infections.


OBJECTIVE
To evaluate the efficacy of itraconazole in the treatment of mild to severe facial seborrheic dermatitis.


METHODS
Sixty patients with moderate to severe seborrheic dermatitis were evaluated in an open non-comparative study. Patients were treated with oral itraconazole, initially 200 mg/day for a week, followed by a maintenance therapy of a single dose of 200 mg every 2 weeks. Four clinical parameters (erythema, scaling, burning, itching) were assessed using a 0-3 score. Mycological evaluation determined the presence of Malassezia spores in the scales using a direct smear.


RESULTS
At the end of the initial treatment significant improvement was reported in three clinical parameters: erythema, scaling, itching. Maintenance therapy led to only slight further improvement. Burning sensation was only mildly improved during the treatment. The quantity of Malassezia spores present in the direct smear decreased throughout the treatment period. No blood test abnormalities were found during the treatment.


CONCLUSIONS
In this study initial treatment with itraconazole was beneficial in patients with moderate to severe seborrheic dermatitis.
Shemer
Avner
A
Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Israel.
Kaplan
Baruch
B
Nathansohn
Nir
N
Grunwald
Marcelo H
MH
Amichai
Boaz
B
Trau
Henri
H
D000328:Adult; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D012628:Dermatitis, Seborrheic / Q000188:drug therapy* / Q000382:microbiology; D005148:Facial Dermatoses / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000935:Antifungal Agents; D017964:Itraconazole