title: Efficacy of topical 4% Quassia amara gel in facial seborrheic dermatitis:a randomized, double-blind, comparative study.
abstract: BACKGROUND
  Seborrheic dermatitis (SD) is a chronic mild skin disorder with high prevalence. Various treatment options are available, including topical antifungals and anti-inflammatories. Antifungal and anti-inflammatory properties of Quassia amara have been reported.
  
  
  OBJECTIVE
  To check the efficacy and safety of a topical gel with 4% Quassia amara extract and compare it with topical 2% ketoconazole and 1% topical ciclopiroxolamine in the treatment of facial SD.
  
  
  METHODS
  A group of 60 patients displaying facial SD were randomly distributed in 3 groups and given either a topical gel with 4% Quassia amara extract, a topical gel with 2% ketoconazole, or a topical gel with 1% ciclopirox olamine for 4 weeks. Disease severity was assessed at the start and weekly along treatment, as well as 4 weeks after the end of treatment. In each selected area, severity of erythema, scaling, pruritus, and papules were scored from 0 to 3, the sum of these values representing the score of SD on the face. This evaluation was conducted at each visit. The decrease in SD score with all 3 products was compared at each visit. At each stage, overall improvement, safety, and tolerability were also assessed.
  
  
  RESULTS
  Of the 60 patients, 54 (90%) completed the study. The 3 therapeutic options resulted to be very effective, with a significant advantage in efficacy for 4% Quassia extract. For the other 2 drugs, the results were in line with those previously published in the literature.
  
  
  CONCLUSIONS
  Topical gel with 4% Quassia extract represents a new, safe, and effective treatment for facial SD.
authors.affiliation: Universidad Nacional de Córdoba, Córdoba, Argentina. chdiehl@hotmail.com
authors.forename: Christian
authors.initials: C
authors.lastname: Diehl
authors.forename: Alicia
authors.initials: A
authors.lastname: Ferrari
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000077768:Ciclopirox; D012628:Dermatitis, Seborrheic / Q000188:drug therapy* / Q000473:pathology; D004311:Double-Blind Method; D005148:Facial Dermatoses / Q000188:drug therapy / Q000473:pathology; D005260:Female; D005782:Gels; D006801:Humans; D007654:Ketoconazole / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010936:Plant Extracts / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011728:Pyridones / Q000008:administration & dosage / Q000627:therapeutic use; D032271:Quassia / Q000737:chemistry*; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D005782:Gels; D010936:Plant Extracts; D011728:Pyridones; D000077768:Ciclopirox; D007654:Ketoconazole