Efficacy and Quality of Life with Oral Fluconazole versus Itraconazole Pulse Therapy in Seborrheic Dermatitis: A Prospective Comparative Study

Introduction:Seborrheic dermatitis (SD) is a chronic, relapsing inflammatory dermatological condition that markedly impairs quality of life. Systemic antifungal therapy with oral azoles is often warranted in moderate-to-severe cases unresponsive to topical agents. This study aimedto compare the clinical efficacy, quality-of-life outcomes, and safety of oral fluconazoleanditraconazole pulse therapy in patients with SD. Material and Methods:A prospective study was conducted in a tertiary care hospital over 6months, from Nov 2024 – April 2025, comparing the efficacy and quality – of – life impact of Oral Fluconazole and Itraconazole pulse therapy in 100 patients with moderate - to - severeSeborrheic Dermatitis: Group A received fluconazole 150 mg once weekly for eight weeks, andGroup B received itraconazole 100 mg twice daily for eight weeks. The Seborrheic Dermatitis Area and Severity Index (SDASI) and Dermatology Life Quality Index (DLQI) were used to assess Clinical Parameters such as Scalp flaking, Erythema and Pruritus (Itching), and patient reportedquality of life, respectively. Statistical analysis included descriptive statistics for baselinedemographics and Repeated Measures ANOVA for evaluating efficacy. Results:Both regimens significantly reduced mean SDASI scores from baseline to Week 8(p<0.001). The reduction was greater with itraconazole than fluconazole, with between-groupdifferences reaching significance at Weeks 6 and 8 (p = 0.008, p < 0.001). DLQI scores improvedsignificantly in both groups, favouring itraconazole (p = 0.002). No serious or treatment-relatedadverse events were recorded, and liver function parameters remained within normal limits.