Lithium gluconate 8% vs. ketoconazole 2% in the treatment of seborrhoeic dermatitis: A multicentre, randomized study

288 patients were used to evaluated the effectiveness of lithium gluconate compared to that of ketoconazole in the treatment of seborrheic dermatitis.

Preparations Compared:

• Lithium gluconate 8% ointment
• Ketoconazole 2% emulsion

Key Takeaways:

• Lithium gluconate produced superior results (22% more effective).
• Complete remission after 4 weeks:
  • 28.1% of lithitum gluconate users
  • 16% of ketoconazole users
• Complete remission after 8 weeks:
  • 57.8% of lithitum gluconate users
  • 32.8% of ketoconazole users
• Adverse effects were reported in 26.3% of lithium users vs 25% of ketoconazole users .
• Lithium gluconate showed better results on secondary symptoms (dryness, burning)
• Complete remission was achieved in

Additional Points of Interest:

• Lithiums’ usefulness for seborrheic dermatitis was first discovered when a reduction of seborrheic dermatitis was noted in patients using lithitum salts for the treatment for psychotic syndrome.
• While patients found ketconazole less sticky, ease of application was considered superior for the lithium gluconate.
• Main adverse reactions included: reddening of the skin, burning, and dryness.
• Exact method in which lithium salts resolve seborrheic dermatitis is unclear. However, several theories include:
  • Inhibition of malassezia furfur
  • Inhibition of free fatty acid production (necessary for growth of malassezia)
  • Anti-inflammatory effect of lithium salts by inhibition of arachidonic acid production

Conclusion:

Lithitum gluconate appears to have better effectiveness then ketoconazole for the treatment of seborrheic dermatitis.

Research Paper Details