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:
0 for 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 areaa of treatment.

Keywords: Ketoconazole, Hydrocortisone, Seborrheic Dermatitis, Infantile