Topical Antifungal Agents for Seborrheic Dermatitis: Systematic Review and Meta-Analysis
Waraphorn Apasrawirote MD*, Montree Udompataikul MD*, Suthee Rattanamongkolgul MD**
Affiliation : * Skin Center, Faculty of Medicine, Srinakharinwirot University Bangkok, Thailand ** Department of Preventive and Social Medicine, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
Objective : Assess the efficacy of topical antifungal agents for seborrheic dermatitis treatment.
Material and Method: A systematic review and meta-analysis of all relevant randomized vehicle-controlled trials of topical
antifungal agents for seborrheic dermatitis treatment were searched. The quality of the enrolled studies was measured by
criteria from Cochrane Collaboration, followed by data extraction. Two reviewers independently assessed the present study
articles. When there was a disagreement between the two reviewers, a consensus was made by the third reviewer. Pooled
relative risk (PRR) statistical analysis was used to determine the efficacy of treatment.
Results : One thousand ninety five studies were reviewed and nine studies were included. Four reports studied the efficacy of
ketoconazole, two of metronidazole, two of ciclopirox, and one of bifonazole. Ketoconazole was more effective than vehicle
[PRR is 5.78 (95% CI, 2.17-15.40)], as was metronidazole [PRR is 1.83 (95% CI: 1.05-3.17)] ciclopirox [PRR is 3.00
(95% CI, 1.86-4.84)], and bifonazole [PRR is 1.86 (95% CI: 0.96-3.59)].
Conclusion : The meta-analysis in the present study showed that the topical antifungal agents that demonstrated strong and
moderate evidence of the efficacy for seborrheic dermatitis treatment were ketoconazole and ciclopirox, respectively. They
could be used as an alternative treatment for seborrheic dermatitis.
Keywords : Topical antifungal agents, Systematic review, Meta-analysis
