Real-World Use of Tapinarof Cream 1% Once Daily in Patients with Seborrheic Dermatitis: A Case Series.

Seborrheic dermatitis (SD) is an inflammatory skin disease with multifactorial etiology, involving genetic and environmental factors. Many conventional therapies for SD (ie, topical antifungals, topical corticosteroids) are associated with incomplete efficacy, frequent and sometimes rapid disease recurrence, and restrictions on duration of therapy and anatomic sites of application. This may be because they cannot target multiple disease processes and/or are limited by safety considerations. Topical roflumilast foam was approved for the treatment of SD in 2023, but additional options are needed. The pathophysiology of atopic dermatitis (AD) and psoriasis have similarities with SD, supporting the hypothesis that tapinarof cream 1% once daily (QD) may be beneficial and well tolerated for patients with SD. Tapinarof is a non-steroidal, topical aryl hydrocarbon receptor agonist approved for the treatment of plaque psoriasis in adults. Tapinarof downregulates pro-inflammatory cytokines implicated in AD and plaque psoriasis, restores the skin barrier through upregulation of skin barrier components, and reduces oxidative stress. Here, we report that tapinarof cream 1% QD used for the treatment of four adults with mild-to-severe SD affecting the face, neck, back, and chest, demonstrated a rapid onset of efficacy and noticeable improvements in disease activity. Efficacy was maintained after treatment discontinuation, indicating a possible remittive effect as previously described in plaque psoriasis. The efficacy and potential remittive effect may be attributed to the unique mechanism of action and clinical profile of tapinarof cream. Tapinarof is a novel topical therapy that may be beneficial for patients with SD.