Pimecrolimus 1% cream, methylprednisolone aceponate 0.1% cream and metronidazole 0.75% gel in the treatment of seborrhoeic dermatitis: a randomized clinical study.
BACKGROUND
Seborrhoeic dermatitis is a common, chronic, papulosquamous dermatosis. Treatment of seborrhoeic dermatitis includes topical treatments such as corticosteroids, antifungals, metronidazole and pimecrolimus.


OBJECTIVE
This study aimed to compare and contrast the efficacy and tolerability of pimecrolimus cream 1%, methylprednisolone aceponate 0.1% cream and metronidazole 0.75% gel topical treatments in the treatment of facial seborrhoeic dermatitis.


METHODS
The study included a total of 64 (32 males and 32 females) consecutive patients with facial seborrhoeic dermatitis. Patients were randomized into three equal groups. One group applied pimecrolimus 1% cream, another group applied methylprednisolone aceponate 0.1% cream, and the third group applied metronidazole 0.75% gel to their facial lesions twice daily for 8 weeks. Assessment of the disease severity was performed at baseline and at weeks 2, 4, and 8. Clinical measures assessed were erythema, scaling and pruritus, which were evaluated using a four-point scale (0-3).


RESULTS
Of the 64 patients, 17 (80%) in the metronidazole group, 21 (100%) in the pimecrolimus group and 22 (100%) in the methylprednisolone aceponate group completed the study. Four patients in the metronidazole group left the study. All of the therapeutic agents were found to be effective; however, the efficacy of pimecrolimus was higher than those of metronidazole and methylprednisolone (p < 0.05). When side effects associated with pimecrolimus and metronidazole were compared, the latter was found to be associated with more side effects (p < 0.05).


CONCLUSIONS
We suggest pimecrolimus to be a therapeutic option for seborrhoeic dermatitis cases that show an unfavourable response to methylprednisolone aceponate.
Cicek
Demet
D
Department of Dermatology, Firat University Faculty of Medicine, Elazig, Turkey. dr.demetcicek@yahoo.com
Kandi
Basak
B
Bakar
Selma
S
Turgut
Dilara
D
D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D012628:Dermatitis, Seborrheic / Q000175:diagnosis / Q000188:drug therapy*; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004643:Emollients / Q000008:administration & dosage / Q000627:therapeutic use; D005145:Face / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use*; D017060:Patient Satisfaction; D012720:Severity of Illness Index; D016559:Tacrolimus / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003879:Dermatologic Agents; D004643:Emollients; D008795:Metronidazole; C117268:pimecrolimus; C078007:methylprednisolone aceponate; D016559:Tacrolimus; D008775:Methylprednisolone