Ratnavel Ravi C, Squire Ruth A, Boorman Graham C
Department of Dermatology, Stoke Mandeville NHS Trust, Aylesbury, UK.
J Dermatolog Treat. 2007;18(2):88-96. doi: 10.1080/16537150601092944.
Ciclopirox olamine (CPO) is a broad-spectrum antifungal with anti-inflammatory properties effective against the yeast implicated in seborrhoeic dermatitis, Malassezia spp. This study compared 1.5% CPO shampoo with 2.0% ketoconazole shampoo and placebo in scalp seborrhoeic dermatitis.
A randomized, double-blind, 4-week treatment period was preceded by a 2-week run-in period and followed by a 2-week run-out period. A total of 350 patients (150 CPO, 150 ketoconazole, 50 placebo) were enrolled. Assessments included scalp area affected, the severity of scaling, erythema, itching and scaling, and overall signs and symptoms.
Both shampoos were significantly more effective than placebo in reducing the area affected. The mean reduction from baseline to end of treatment was 48.2 cm(2) with CPO, 41.4 cm(2) with ketoconazole and 20.0 cm(2) with placebo. Patients rated the CPO shampoo as superior to placebo (p<0.001) and ketoconazole shampoo (p<0.05) on the basis of overall signs and symptoms. Assessments of itching and scaling were also significantly in favour of the CPO shampoo over placebo at the end of treatment. All three shampoos were well tolerated.
CPO shampoo was superior to placebo and at least as effective as ketoconazole shampoo in treating scalp seborrhoeic dermatitis. Patients rated the overall improvement as better with CPO than with ketoconazole shampoo.
环吡酮胺（CPO）是一种具有抗炎特性的广谱抗真菌药，对脂溢性皮炎相关的酵母马拉色菌属有效。本研究比较了1.5% CPO洗发水与2.0%酮康唑洗发水及安慰剂治疗头皮脂溢性皮炎的效果。
在为期4周的随机、双盲治疗期之前有2周的导入期，之后有2周的洗脱期。共纳入350例患者（150例使用CPO，150例使用酮康唑，50例使用安慰剂）。评估内容包括头皮受累面积、脱屑、红斑、瘙痒及脱屑的严重程度以及总体体征和症状。
两种洗发水在减少受累面积方面均显著优于安慰剂。从基线到治疗结束，CPO组平均减少48.2 cm²，酮康唑组减少41.4 cm²，安慰剂组减少20.0 cm²。基于总体体征和症状，患者将CPO洗发水评为优于安慰剂（p<0.001）和酮康唑洗发水（p<0.05）。在治疗结束时，对瘙痒和脱屑的评估也显著表明CPO洗发水优于安慰剂。所有三种洗发水耐受性良好。
CPO洗发水在治疗头皮脂溢性皮炎方面优于安慰剂，且至少与酮康唑洗发水效果相当。患者对CPO洗发水总体改善情况的评价优于酮康唑洗发水。
