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.