0305 Topical and oral phosphodiesterase-4 inhibitors for refractory seborrheic dermatitis: A systematic review

Document Type

Conference Proceeding

Publication Date

8-1-2025

Publication Title

J Invest Dermatol

Keywords

antifungal agent, apremilast, corticosteroid, crisaborole, interleukin 10, phosphodiesterase IV, phosphodiesterase IV inhibitor, roflumilast, adverse drug reaction, antifungal activity, chronic inflammation, conference abstract, drug therapy, erythema, follow up, human, immune dysregulation, immune response, nausea, pruritus, rhinopharyngitis, seborrheic dermatitis, side effect, special situation for pharmacovigilance, systematic review, therapy, topical drug administration

Abstract

Seborrheic dermatitis (SD) is a chronic inflammatory condition characterized by erythema, scaling, and pruritus, primarily affecting sebaceous-rich areas. Treatment typically includes antifungals, corticosteroids, and other anti-inflammatory medications. Recently, Phosphodiesterase-4 (PDE-4) inhibitors emerged as a promising therapeutic option for managing treatment-resistant SD cases. Current literature lacks a summary of this rising therapy option. We present a systematic review summarizing the efficacies and outcomes regarding treatment of SD with topical and oral PDE-4 inhibitors. Of 200 articles screened from three databases, authors included 7 articles describing 638 patients. The most common treatment utilized was topical roflumilast 0.3% applied daily (94.51%). Topical crisaborole 2% (5.02%) and oral apremilast 30mg (0.47%) were also used. Average follow-up time was 1.91 months. A majority of patients, 50.31%, experienced improvement in their condition, 28.37% achieved full resolution, and 21.32% showed no change. Only 16.77% reported adverse effects like nausea and nasopharyngitis. By increasing cAMP levels, suppressing pro-inflammatory cytokines, and promoting anti-inflammatory cytokines (such as IL-10), PDE-4 inhibitors downregulate the skin’s inflammatory response. Modulating the immune response is beneficial in SD where immune dysregulation is a key factor. Unlike corticosteroids, PDE-4 inhibitors provide effect without long-term use side effects, such as skin thinning and barrier dysfunction. The use of PDE-4 inhibitors represents a significant advancement in the management of SD, especially in patients needing long-term management, with these results highlighting their efficacy and tolerability. As more clinical data become available, PDE-4 inhibitors are likely to become a cornerstone in the treatment of SD.

Volume

145

Issue

8

First Page

S53

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