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Comparative study of 2% ketoconazole cream and 1% hydrocortisone cream in the treatment of infantile seborrheic dermatitis.

OBJECTIVE
To compare efficacy of 2% ketoconazole cream with 1% hydrocortisone cream in the treatment of infantile seborrheic dermatitis (ISD). This study recruited infants of 2 weeks to 2 years old with a clinical diagnosis of infantile seborrheic at the Department of Pediatrics, King Chulalongkorn Memorial Hospital from December 2001 to November 2003.


METHOD
The severity of the rash of the patients was examined in terms of erythema, scale and crust before treatment based on a scoring system comparing two sides (left and right) of the lesion with numeral representation for it a severity, namely: Ofor no lesion; 1, mild; 2, moderate; and 3, severe. They were treated with 2% ketoconazole cream on the left side of the lesion and 1% hydrocortisone cream on the right side of the lesion, twice a day.


RESULTS
The responses of treatment of 2% ketoconazole cream compared with 1% hydrocortisone cream in 48 patients had no statistical significant difference at 2-3 days of treatment and 4-7 days of treatment. By one week, both 2% ketoconazole cream and 1% hydrocortisone cream have significant clinical improvement of the lesion. The skin lesions were cleared in 31% of the ketoconazole group and 35% of the hydrocortisone group. All skin lesions were cleared by the end of the second week.


CONCLUSION
The efficacy of 2% ketoconazole cream and 1% hydrocortisone cream in the treatment of ISD was not significantly different. Ketoconazole is another option for the treatment of ISD, to avoid the side effects of topical corticosteroid in long-term use and on large surface area of treatment.