title: A retrospective descriptive study of oral azole antifungal agents in patients with patch test-negative head and neck predominant atopic dermatitis.
abstract: BACKGROUND
  Head and neck dermatitis is a subtype of atopic dermatitis driven by Malassezia yeast.
  
  
  OBJECTIVE
  We sought to evaluate the response of these patients to systemic azole antifungals.
  
  
  METHODS
  We queried the electronic medical records from our institution for patients that were referred for allergy patch testing, were ultimately given the diagnosis of head and neck dermatitis, and were treated with oral azole antifungals over a 2-year period.
  
  
  RESULTS
  Twenty-four patients met inclusion criteria and were analyzed. Most patients noted their characteristic flare beginning during their teenage, young adult, or adult years. All were noted to have some involvement of the head and neck, and 17 responded to treatment. The mean time taking an azole antifungal medication was 8 months, with a mean overall follow-up of 10 months.
  
  
  CONCLUSIONS
  This was a retrospective descriptive study, from a single institution, of a limited number of patients, and did not use a validated scoring system.
  
  
  CONCLUSIONS
  Itraconazole and other azole antifungals were an effective treatment for more than two-thirds of adult patients with head and neck predominant atopic dermatitis.
authors.affiliation: Division of Dermatology, Ohio State University College of Medicine, Columbus, Ohio; Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Benjamin H
authors.initials: BH
authors.lastname: Kaffenberger
authors.affiliation: Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Jason
authors.initials: J
authors.lastname: Mathis
authors.affiliation: Division of Dermatology, Ohio State University College of Medicine, Columbus, Ohio; Ohio State University College of Medicine, Columbus, Ohio; Ohio State University Contact and Occupational Dermatitis Center, Columbus, Ohio. Electronic address: Matt.Zirwas@osumc.edu.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Zirwas
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001393:Azoles; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000382:microbiology; D009783:Dermatitis, Occupational / Q000188:drug therapy; D012628:Dermatitis, Seborrheic / Q000188:drug therapy; D003881:Dermatomycoses / Q000188:drug therapy*; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008290:Malassezia; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D000935:Antifungal Agents; D001393:Azoles; D017964:Itraconazole
keywords: Malassezia; atopic dermatitis; contact dermatitis; eczema; fluconazole; head and neck dermatitis; itraconazole; ketoconazole; occupational dermatitis; seborrheic dermatitis