Itraconazole in adult atopic dermatitis

Aim. Clinical evidences showed that the clinical course of atopic dermatitis (AD) is often complicated by bacterial super-infections. In cutaneous areas, as face and neck, atopic dermatitis could be exacerbated by colonization of Pityrosporum species. In this study, the therapeutical activity of systemic Itraconazole has been evaluated in face and neck atopic dermatitis in which Pityrosporum species colonization has been demonstrated. Methods. A total of 8 adult patients were enrolled in the study. All patients had a high-grade face and neck atopic dermatitis and a reported resistance to all previous scheduled treatments. Itraconazole was given at the dose of 200 mg/day for 7 consecutive days. The evaluation of clinical effects has been scheduled before the treatment and after 2 and 4 weeks. Results. At the end of the treatment, clinical results have been classified as good in 50% of cases, excellent in 37.5% and negative in 12.5% of cases. Microscopic observation of cutaneous scales taken from affected areas gave positive results in 7 out of 8 enrolled patients. Conclusion. The study pointed out the therapeutical effect of Itraconazole in high-grade face and neck atopic dermatitis in which Malassezia colonization has been proven. Itraconazole has a specific effect on yeasts proliferation and it improves the clinical spectrum through its anti-inflammatory properties. It seems mandatory, to check for the presence of bacteria, and/or mycotic super-infections, in all the cases of high grade face and neck atopic dermatitis showing therapeutic resistance to common systemic and/or topical preparations.