Betamethasone-17-valerate compared with ketoconazole for topical treatmentof seborrhoeic dermatitis of the scalp in adults. Results of a Dutch multicentre study

BACKGROUND: Only a few reports describe direct comparisons between corticos teroids and antimycotics in the topical treatment of seborrhoeic dermatitis (SD). OBJECTIVE: The clinical effects of betamethasone-17-valerate and ket oconazole were compared during early and later treatment stages of well-def ined SD of the scalp in adults. METHODS: Patients were randomly allocated t o 4 weeks, open-label treatment with betamethasone-17-valerate lotion 0.1% or ketoconazole hydrogel 2%. Patients in remission were followed up for up to 8 weeks or until recurrence. During treatment. disease activity was asse ssed after 1, 2 and 4 weeks of treatment and after 2 and 8 weeks during fol low-up, or at recurrence. RESULTS: Of 69 patients entering the treatment ph ase, 34 received betamethasone and 35 received ketoconazole. After 1 week, and even more after 2 weeks, treatment with betamethasone produced a statis tically significantly greater improvement than ketoconazole. After 2 weeks, 20 patients (59%) in the betamethasone group and 9 (26%) in the ketoconazo le group were in remission or were markedly improved in the patients' opini on. In the investigators' opinion, equivalent figures were 18 (53%) and 6 ( 17%), respectively, After the 4-week treatment period, and during the postt reatment follow-up, there were no significant differences. CONCLUSION: In t his study betamethasone-17-valerate lotion initially produced a faster remi ssion of overall disease activity and individual symptoms than ketoconazole hydrogel. However, after a 4-week treatment period, a statistically signif icant difference no longer existed between the two treatment groups.