Posted by: Chris Maloney | July 2, 2011

Seborrheic Dermatitis: Just A Fungal Infection?

Picture of Seborrhoeic Dermatitis.

Image via Wikipedia

If you read about Seborrheic Dermatitis, it’s pretty grim.  A chronic skin irritation worsened by stress that runs in families and can last your whole life.  That’s from the NIH.  (Here’s its page on it.)

But a recent analysis of studies found that antifungals are quite effective at alleviating it.  (Study below)  Since the conventional wisdom is that fungal infections are opportunists that are only occasionally present, will this change and will Seborrheic Dermatitis be reclassified as a fungal response (like acne rosacea).  If that happens, will they stop prescribing steroids for it because the steroids would allow the fungus to spread? 

J Med Assoc Thai. 2011 Jun;94(6):756-60.

Topical antifungal agents for seborrheic dermatitis: systematic review and meta-analysis.

Apasrawirote W, Udompataikul M, Rattanamongkolgul S.

SourceSkin Center, Faculty of Medicine, Srinakharinwirot University Bangkok, Thailand.


OBJECTIVE: Assess the efficacy of topical antifungal agents for seborrheic dermatitis treatment.

MATERIAL AND METHOD: A systematic review and meta-analysis of all relevant randomized vehicle-controlled trials of topical antifungal agents for seborrheic dermatitis treatment were searched. The quality of the enrolled studies was measured by criteria from Cochrane Collaboration, followed by data extraction. Two reviewers independently assessed the present study articles. When there was a disagreement between the two reviewers, a consensus was made by the third reviewer. Pooled relative risk (PRR) statistical analysis was used to determine the efficacy of treatment.

RESULTS: One thousand ninety five studies were reviewed and nine studies were included. Four reports studied the efficacy of ketoconazole, two of metronidazole, two of ciclopirox, and one of bifonazole. Ketoconazole was more effective than vehicle [PRR is 5.78 (95% CI, 2.17-15.40)], as was metronidazole [PRR is 1.83 (95% CI: 1.05-3.17)] ciclopirox [PRR is 3.00 (95% CI, 1.86-4.84)], and bifonazole [PRR is 1.86 (95% CI: 0.96-3.59)].

CONCLUSION: The meta-analysis in the present study showed that the topical antifungal agents that demonstrated strong and moderate evidence of the efficacy for seborrheic dermatitis treatment were ketoconazole and ciclopirox, respectively. They could be used as an alternative treatment for seborrheic dermatitis.



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