The response of seborrhoeic dermatitis to ketoconazole

Abstract

A randomized double-blind placebo-controlled cross-over study was made of ketoconazole 200 mg daily in 19 patients with seborrheic dermatitis. All had scalp lesions and 16 had seborrheic dermatitis at other sites. Responses were measured by clinician and patients independently, using a linear analog scale. Body and scalp lesions and itch regressed considerably and significantly with ketoconazole in all but 5 patients, 3 of whom subsequently responded to a higher dose. The patients studied with seborrheic dermatitis had been sent by their family doctors in answer to a request for patients with dandruff, and the clinical difference between the 2 was only of degree. Three patients with dandruff without erythema were studied separately using the same study design: all 3 responded similarly to those with seborrheic eczema. Pityrosporum yeast infection is the immediate cause of seborrheic dermatitis and dandruff is its mildest manifestation.