Topical antimycotic treatment of atopic dermatitis in the head/neck area. A double-blind randomised study

In order for us to evaluate the effect of topical antimycotic treatment in patients with atopic dermatitis affecting the head and neck area, 60 patients (36 females and 24 males; median age 28 years; range 14-53 years) were included in a double-blind study during 6 weeks. Of the 53 evaluable patients, 55% had positive skin prick tests to Pityrosporum ovale. In addition to oral antibiotic treatment, patients in group A (n = 26) were given miconazole-hydrocortisone cream and ketoconazole shampoo, whereas patients in group B (n = 27) were given hydrocortisone cream and placebo shampoo. At the start of the study P. ovale cultures were positive in 83% of all patients (no significant difference between the groups). After 4 weeks of treatment, there was a decrease in P. ovale colonisation in group A (p < 0.001) but not in group B. Patients in both groups improved (p < 0.001). The decrease in eczema score did not differ between group A and group B after 4 weeks' treatment. A further decrease of the eczema score was seen in both groups at the end of the study, but no difference was found between the groups.