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Abstract
BACKGROUND: Only a few reports describe direct comparisons between corticosteroids and antimycotics in the topical treatment of seborrhoeic dermatitis (SD). OBJECTIVE: The clinical effects of betamethasone-17-valerate and ketoconazole were compared during early and later treatment stages of well-defined SD of the scalp in adults. METHODS: Patients were randomly allocated to 4 weeks, open-label treatment with betamethasone-17-valerate lotion 0.1% or ketoconazole hydrogel 2%. Patients in remission were followed up for up to 8 weeks or until recurrence. During treatment, disease activity was assessed after 1, 2 and 4 weeks of treatment and after 2 and 8 weeks during follow-up, or at recurrence. RESULTS: Of 69 patients entering the treatment phase, 34 received betamethasone and 35 received ketoconazole. After 1 week, and even more after 2 weeks, treatment with betamethasone produced a statistically significantly greater improvement than ketoconazole. After 2 weeks, 20 patients (59%) in the betamethasone group and 9 (26%) in the ketoconazole group were in remission or were markedly improved in the patients' opinion. In the investigators' opinion, equivalent figures were 18 (53%) and 6 (17%), respectively. After the 4-week treatment period, and during the posttreatment follow-up, there were no significant differences. CONCLUSION: In this study betamethasone-17-valerate lotion initially produced a faster remission of overall disease activity and individual symptoms than ketoconazole hydrogel. However, after a 4-week treatment period, a statistically significant difference no longer existed between the two treatment groups.