Seborrheic dermatitis (SD) is a chronic common inflammatory skin disease, affecting 1-3% of the adult population which is a common chronic erythematous scaly eruption usually seen in areas rich in sebaceous glands, the scalp, face, chest, back, and flexural areas.

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.

There are several topical such as zinc pyrithione, selenium sulfide; antifungal agents and steroids are usually used in the treatment of mild disease. These topical agents give temporary and partial relief but are less effective in more severe cases.

Itraconazole is a highly keratinophilic and lipophilic triazole, secreted in sebum which is a major route by which the drug reaches the stratum corneum.

Systemic antifungal agents including itraconazole, which are known to be effective in the treatment of Malassezia species infection, were suggested as one of the therapeutic modalities in cases of moderate to severe seborrheic dermatitis

This study was done to evaluate the efficacy of itraconazole in the treatment of seborrheic dermatitis. 

TAKE HOME MESSAGE

Sixty patients with Seborrheic dermatitis were evaluated in an open non-comparative study. Patients were treated with itraconazole capsule 100 mg twice a day for a week; then after a 3-week interval 100 mg capsule was given twice a day for 2 days of following months for two consecutive months.

Four clinical parameters (Itching, burning erythema, scaling, and seborrhea) were assessed

At the end of the initial treatment significant improvement was reported in four clinical parameters: Itching, burning erythema, scaling, and seborrhea.

Maintenance therapy led to further improvement slightly. Burning sensation mildly improved during the treatment.

The quantity of Malassezia spores present in the direct smear decreased throughout the treatment period. Blood test abnormalities were not found during the treatment.

Conclusion:

Since seborrheic dermatitis is a relapsing condition, use of topical agents may be unsuitable on a long-term basis and oral treatment is preferred by patients who are refractory to topical treatment, relapse frequently, or have disease that affects large areas.

The results of this study indicate that Itraconazole is effective for the therapy of moderate to severe cases of seborrheic dermatitis.