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Systemic ketoconazole for yeast allergic patients with atopic dermatitis
1Department of Dermatology and Venereology, University Hospital, Lund, Sweden. Ove.Back@derm.lu.se
Summary
Oral ketoconazole significantly reduced yeast-specific IgE and total IgE in adult atopic dermatitis (AD) patients. This treatment improved clinical scores, unlike placebo, which relied on topical steroid use.
Area of Science:
- Dermatology
- Immunology
- Mycology
Background:
- Adult atopic dermatitis (AD) patients often exhibit sensitization to Malassezia furfur/Pityrosporum orbiculare.
- This yeast is implicated in the pathogenesis of AD, particularly with head-neck distribution.
Purpose of the Study:
- To evaluate the efficacy of oral ketoconazole in yeast-allergic adult AD patients.
- Assessed impact on immunological and clinical parameters.
Main Methods:
- A randomized, double-blind, placebo-controlled study.
- 29 adult AD patients with elevated IgE and M. furfur/P. orbiculare specific IgE were enrolled.
- Patients received either 200 mg oral ketoconazole or placebo daily for 3 months, with topical betamethasone as rescue therapy.
Main Results:
- Ketoconazole group showed significant decreases in M. furfur/P. orbiculare and Candida albicans specific IgE, and total serum IgE.
- No significant influence on Dermatophagoides pteronyssinus sensitization.
- Clinical score (SCORAD) improved in both groups; improvement correlated with topical steroid use in the placebo group, but not the ketoconazole group.
Conclusions:
- Oral ketoconazole demonstrates efficacy in reducing yeast-specific IgE and improving clinical symptoms in yeast-allergic adult AD patients.
- Ketoconazole may offer a therapeutic benefit independent of topical steroid use.