Itraconazole and Treating Seb Derm

Written by on January 16, 2006 in seborrheic dermatitis with 1 Comment

Oral itraconazole for the treatment of seborrhoeic dermatitis: an open, noncomparative trial

Journal of the European Academy of Dermatology & Venereology Volume 19 Page 172 – March 2005, Volume 19 Issue 2

O Kose, H Erbil, AR Gur

Background Seborrhoeic dermatitis is an inflammatory cutaneous disorder in which the colonization of the affected area by Malassezia has been proved to play a key role.

Objective To perform a noncomparative open clinical study with oral itraconazole capsule (200 mg/day ? 7 days) and consecutive usage 200 mg/day for the first 2 days of the following 2 months in patients with seborrhoeic dermatitis.

Methods Twenty-nine patients were enrolled to determine the efficacy and safety of oral itraconazole. The patients were evaluated according to itching, burning, erythema, desquamation and seborrhoea, each scored on a 0–4 scale on days 15 (T15), 30 (T30), 60 (T 60) and 90 (T90). Itraconazole capsule 100 mg was given twice a day for 1 week and then, after a 3-week interval, patients used itraconazole capsule 200 mg/day for the first 2 days of the following 2 months. The clinical response was graded as markedly effective, effective, moderate or ineffective.

Results A clinical improvement (evaluated as markedly effective or effective) was observed in 23 patients (83%) at T15, 21 (76%) at T30, 20 (72%) at T60 and 17 (61%) at T90. At baseline, the mean ± SD total clinical scores were 10.44 ± 2.45, 1.98 ± 0.5, 2.97 ± 1.12, 3.15 ± 1.74 and 3.30 ± 1.90 at T0, T15, T30, T60 and T90, respectively. Compared with baseline values, itraconazole capsule significantly reduced the mean ± SD total score as well as individual erythema and desquamation (Wilcoxon’s signed test-two tailed) (P < 0.0001). No drug-related systemic adverse event was observed during the study.

Conclusions Seborrhoeic dermatitis shows marked reduction in inflammation when treated with itraconazole. The anti-inflammatory activity of oral itraconazole and efficacy on Malessezia suggests that itraconazole capsule will be first oral treatment option in future in severe seborrhoeic dermatitis.


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About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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1 Reader Comment

  1. Ralph A.Miranda, MD, FACAM says:

    Use of systemic antifungals for treatment of a reactive skin condition long associated with a fungus (pityrosporum ovale) especially since the fairly deeply embedded sebaceous glands seem to be the target of the lipophilic fungus, and most topical preparations have limited penetration of beyond the epidermis.
    Because of the potential for adverse effects with the azoles like itraconazole, in a patient with Parkinson’s who is already dealing with multiple other systemic medications requiring hepatic detoxication, I am considering adding a chitin inhibitor, Lufenuron.
    I believe that the fact that this agent is inert in mammals, not metabolized by the liver or any other human organ, is secreted intact in the bile, and kills fungus by a mechanism distinct from that of the azoles makes it an ideal agent for this purpose.
    Do you have an opinion or any thoughts to share?

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