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Fakultas Kedokteran dan Kesehatan

Universitas Muhammadiyah Jakarta


2014
Comparison the Efficacy of Fluconazole and
Terbinafine in Patients with Moderate to Severe
Seborrheic Dermatitis
Narges Alizadeh, Hamed Monadi Nori, Javad Golchi, Shahriar S. Eshkevari, Ehsan
Kazemnejad, Abbas Darjani
Department of Dermatology, Razi Hospital, Guilan University of Medical Science, Rahst, Iran
Department of Preventive and Community Medicine, Guilan University of Medical Science, Rahst, Iran
Clinical Study
Dipresentasikan oleh :
Riyan Sopiyan, S.Ked
Dokter Pembimbing :
Dr. Endang Triwahyuni, SpKK, M.Kes
Introduction
Dermatitis seboroik merupakan kelainan inflamasi kronik kulit yang terbatas pada
area tertentu di kulit seperti skalp, wajah, tubuh atas, dan flexure. Hal ini diduga
berkaitan dengan produksi sebum berlebih dan jamur Malassezia yang normal
berada di tubuh.
Kortikosteroid
Prednison 20 30
mg/hari
Isotretinoin
0.1-0.3 mg/kgBB/hari
Narrow Band UVB (TL-
01)
3x/minggu selama 8 minggu
Ketokonazole
200mg/hari
Flukonazole
300 mg/minggu 4 minggu
Terbinafine
250mg/hari
VS
Material and Method
?
Pasien dermatitis
seboroik tanpa
riwayat
penggunaan
steroid, antifungal
atau obat topikal
atau sistemik lain
untuk minimal 2
minggu sebelum
studi
Memiliki riwayat
CRF, gagal hati,
psoriasis, infeksi
HIV, alergi
terbinafine atau
flukonazole,
sedang menyusui.
Include
exclude
*tes lab: CBC, BUN, Cr,
AST, ALT, dan ALK-Ph
Study Population
Material and Method
Severity Index
Seborrheic Dermatitis Area
Severity Index (SDASI score)
(mild = 0 79, moderate = 8-15.9 ,
severe > 16)
Itching grading
(0 = absent, 1 = mild, 2 = moderate, 3 =
severe)
Statistical analysis
Independent T-Test
Turkey-Kramer test
Mann-Whitney
test
Wilcoxon
test
ANOVA
SPSS V.16 P<0.05
Result
Discussion
Pada studi ini, kedua obat yang diuji baik terbinafine maupun fluconazole efektif
sebagai pengobatan independen dimana terbinafine menurunkan SDASI lebih
baik dibandingkan dengan fluconazole
Terbinafine merupakan
antifungal spektrum luas yang
memiliki efek antiinflamasi
dan bersifat lipofilik
Fluconazole harus diresepkan
dengan dosis yang lebih tinggi
untuk mencapai MIC (minimum
inhibitory concentration) optimal
Pola pemberian fluconazole 1x
perminggu merupakan keuntungan
tersendiri bagi pasien.
Terima Kasih
J. Berth-Jones, Seborrheic dermatitis, in Tony Burns. RooksText Book of Dermatology, vol. 23, pp. 29
31, Blackwell, London,UK, 7th edition, 2010.
A. Comert, N. Bekiroglu, O. Gurbuz, and T. Ergun, Efficacy of oral fluconazole in the treatment of
seborrheic dermatitis: a placebo-controlled study, American Journal of Clinical Dermatology,vol. 8, no. 4,
pp. 235238, 2007.
A. K. Gupta and R. Bluhm, Seborrheic dermatitis, Journal of the European Academy of Dermatology
and Venereology, vol. 18, no. 1, pp. 1326, 2004.
J. R. Schwartz, Treatment of seborrheic dermatitis of the scalp,Journal of Cosmetic Dermatology, vol.
6, no. 1, pp. 1822, 2007.
G. Plewig and T. Jansen, Seborrheic dermatitis, in Fitzpatricks Dermatology in General Medicine, K.
Wolff, Ed., pp. 219225, McGraw-Hill, New York, NY, USA, 7th edition, 2008.
L. G. Zisova, Fluconazole and its place in the treatment of seborrheic dermatitisnew therapeutic
possibilities, Folia Medica, vol. 48, no. 1, pp. 3945, 2006.
E. Scaparro, G. Quadri, G. Virno, C. Orifici, and M. Milani, Evaluation of the efficacy and tolerability of
oral terbinafine (Daskil) in patients with seborrhoeic dermatitis. A multicentre,
randomized, investigator-blinded, placebo-controlled trial, British Journal of Dermatology, vol. 144,
no. 4, pp. 854857, 2001.
N. Cassano, A. Amoruso, F. Loconsole, and G. A. Vena, Oral terbinafine for the treatment of seborrheic
dermatitis in adults, International Journal of Dermatology, vol. 41, no. 11, pp. 821822, 2002.
V. Baysal, M.Yildirim, C. Ozcanli, andA.M.Ceyhan, Itraconazole in the treatment of seborrheic
dermatitis: a new treatment modality, International Journal of Dermatology, vol. 43, no. 1,
pp. 6366, 2004.
G.A.Vena, G.Micali,P. Santoianni, N. Cassano, andE.Peruzzi, Oral terbinafine in the treatment of multi-
site seborrhoic dermatitis: a multicenter, double-blind placebo-controlled study, International journal of
immunopathology and pharmacology, vol. 18, no. 4, pp. 745753, 2005.
K. C. Miranda, C. R. de Araujo, C. R. Costa, X. S. Passos, O. De Fatima Lisboa Fernandes, and M. do
Rosario Rodrigues Silva, Antifungal activities of azole agents against the Malassezia species, International
Journal of Antimicrobial Agents, vol. 29, no. 3, pp. 281284, 2007.

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