Fakultas Kedokteran dan KesehatanUniversitas Muhammadiyah Jakarta

2014

Comparison the Efficacy of Fluconazole and Terbinafine in Patients with Moderate to Severe

Seborrheic DermatitisNarges Alizadeh, Hamed Monadi Nori, Javad Golchi, Shahriar S. Eshkevari, Ehsan Kazemnejad, Abbas

Darjani

Department of Dermatology, Razi Hospital, Guilan University of Medical Science, Rahst, IranDepartment of Preventive and Community Medicine, Guilan University of Medical Science, Rahst, Iran

Clinical Study

Dipresentasikan oleh :

Riyan Sopiyan, S.KedDokter Pembimbing :

Dr. Endang Triwahyuni, SpKK, M.Kes

IntroductionDermatitis seboroik merupakan kelainan inflamasi kronik kulit yang terbatas pada

area tertentu di kulit seperti skalp, wajah, tubuh atas, dan flexure. Hal ini diduga berkaitan dengan produksi sebum berlebih dan jamur Malassezia yang normal

berada di tubuh.

KortikosteroidPrednison 20 – 30

mg/hari

Isotretinoin0.1-0.3 mg/kgBB/hari

Narrow Band UVB (TL-01)

3x/minggu selama 8 minggu

Ketokonazole200mg/hari

Flukonazole300 mg/minggu 4 minggu

Terbinafine250mg/hariVS

Material and Method

?Pasien dermatitis

seboroik tanpa riwayat

penggunaan steroid, antifungal atau obat topikal atau sistemik lain untuk minimal 2 minggu sebelum

studi

Memiliki riwayat CRF, gagal hati,

psoriasis, infeksi HIV, alergi

terbinafine atau flukonazole,

sedang menyusui.

Include exclude

*tes lab: CBC, BUN, Cr, AST, ALT, dan ALK-Ph

Study Population

Material and MethodSeverity Index

Seborrheic Dermatitis Area Severity Index (SDASI score)

(mild = 0 – 79, moderate = 8-15.9 , severe > 16)

Itching grading (0 = absent, 1 = mild, 2 = moderate, 3 =

severe)

Statistical analysis

Independent T-Test

Turkey-Kramer test

Mann-Whitney test

Wilcoxon test

ANOVASPSS V.16 P<0.05

Result

DiscussionPada studi ini, kedua obat yang diuji baik terbinafine maupun fluconazole efektif

sebagai pengobatan independen dimana terbinafine menurunkan SDASI lebih baik dibandingkan dengan fluconazole

Terbinafine merupakan antifungal spektrum luas yang

memiliki efek antiinflamasi dan bersifat lipofilik

Fluconazole harus diresepkan dengan dosis yang lebih tinggi

untuk mencapai MIC (minimum inhibitory concentration) optimal

Pola pemberian fluconazole 1x perminggu merupakan keuntungan

tersendiri bagi pasien.

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