Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada; Mediprobe Laboratories, London, ON, Canada.
J Eur Acad Dermatol Venereol. 2014 Jan;28(1):16-26. doi: 10.1111/jdv.12197. Epub 2013 Jun 26.
Seborrheic dermatitis (SD) is normally treated with topical corticosteroids and antifungals. Oral therapies can be prescribed in severe or unresponsive cases. This review aims to assess the quantity and quality of published reports on oral therapies for SD. MEDLINE and Embase databases and the reference listings of publications were searched for any publication using oral treatment for SD. The quality of the included publications was assessed using a modified 27 item checklist by Downs and Black. Twenty-one publications (randomized controlled trials, open trials and case reports) covering eight oral therapies (itraconazole, terbinafine, fluconazole, ketoconazole, pramiconazole, prednisone, isotretinoin and homeopathic mineral therapy) were identified. Most of the publications investigated oral antifungals and the quality of the evidence was generally low. The clinical efficacy outcome reported varied considerably between the studies, preventing statistical analysis and direct comparison between treatments. However, ketoconazole therapy was associated with more relapses compared with other treatments. Itraconazole dosing regimen for SD was generally 200 mg/day for the first week of the month followed by 200 mg/day for the first 2 days for 2-11 months. Terbinafine was prescribed at 250 mg/day either as a continuous (4-6 weeks) or as an intermittent regimen (12 days per month) for 3 months. Fluconazole has administered daily (50 mg/day for 2 weeks) or weekly (200-300 mg) for 2-4 weeks. Ketoconazole dosing regimen was 200 mg daily for 4 weeks. Finally, a single 200 mg dose of pramiconazole was administered to patients. This review also highlights key areas for consideration when designing future studies.
脂溢性皮炎（SD）通常采用局部皮质类固醇和抗真菌药物治疗。在严重或无反应的情况下，可以开具口服治疗药物。本综述旨在评估有关 SD 口服治疗的已发表报告的数量和质量。检索了 MEDLINE 和 Embase 数据库以及出版物的参考文献列表，以查找任何使用 SD 口服治疗的出版物。使用 Downs 和 Black 修改后的 27 项清单评估纳入出版物的质量。共确定了 21 项研究（随机对照试验、开放试验和病例报告），涵盖了 8 种口服治疗方法（伊曲康唑、特比萘芬、氟康唑、酮康唑、普莫康唑、泼尼松、异维 A 酸和顺势疗法矿物疗法）。大多数出版物研究了口服抗真菌药，证据质量普遍较低。研究之间报告的临床疗效结果差异很大，无法进行统计学分析和治疗之间的直接比较。然而，酮康唑治疗与其他治疗相比，复发率更高。SD 的伊曲康唑剂量方案通常为每月第一周 200 mg/天，然后第一个月的前两天 200 mg/天，持续 2-11 个月。特比萘芬每天 250 mg 连续（4-6 周）或间歇（每月 12 天）给药 3 个月。氟康唑每日（2 周 50 mg/天）或每周（200-300 mg）给药 2-4 周。酮康唑剂量方案为每天 200 mg，持续 4 周。最后，给患者单次服用 200 mg 普莫康唑。本综述还强调了在设计未来研究时需要考虑的关键领域。
