Efficacy of fluconazole and itraconazole in the treatment of pityriasis versicolor

Background and design: Pityriasis versicolor is a common superficial fungal skin infection which occurs particularly in warm and humid climates in the presence of predisposing factors and which tends to recur. Recently, new systemic antifungal agents have become preferable in the treatment of pityriasis versicolor due to their simplicity in application and ability to decrease recurrence. In this study, the efficacy of fluconazole and itraconazole, two mostly utilized systemic antifungals, on patients suffering from pityriasis versicolor was aimed to be evaluated. Materials and methods: 72 patients diagnosed as pityriasis versicolor in the Istanbul University, Istanbul Medical Faculty, Department of Dermatology were investigated in the study. 39 of these patients were given 200
mg itraconazole per day for five days and the rest were given a single dose of 400 mg fluconazole only once throughout the study. The clinical and mycological evaluations were held right before the research began and at the 14th, 30th and 60th days after the treatment ended, by statistical comparison of the rates of improvement, responselessness and recurrence, using the ‘student-t’, ‘chi-square’ and ‘Fischer’s exact tests’ methods. Results: There was not significant difference between the statistical results of the two groups obtained from the evaluations at the 14th, 30th and 60th days. The clinical and mycologic improvement rates were 81.8% in the fluconazole-given group and 84.6% in the itraconazole-given group at the 60th day. Recurrence was recorded
in two patients of each group when the study ended and none of these showed signs of serious side effects. Conclusion: Itraconazole and fluconazole applied in the above mentioned posologies have shown to be competent with each other in means of effectiveness and safety in the successful treatment of pityriasis versicolor; however, the shorter period of treatment with fluconazole may be considered as an advantage of this agent over itraconazole.

Pitiriyazis versikolorda sistemik flukonazol ve itrakonazolün etkinliği: Karşılaştırmalı çalışma

Pitiriyazis versikolor, özellikle sıcak nemli iklimlerde predispozan faktörlerin varlığında ortaya çıkan ve tekrarlamaya eğilimi olan derinin yüzeyel mantar infeksiyonudur. Son yıllarda, kullanım kolaylıkları ve nüksleri azaltmaları açısından, pitiriyazis versikolor tedavisinde yeni sistemik antifungaller seçenek haline gelmişlerdir. Bu çalışmada sistemik antifungallerden flukonazol ve itrakonazolün pitiriyazis versikolorlu hastalarda klinik etkinliğini değerlendirmek amaçlandı. Bunun için, İstanbul Tıp Fakültesi Dermatoloji Anabilim Dalı polikliniğine başvuran, pitiriyazis versikolor tanılı 72 hastanın 33'üne tek doz 400 mg flukonazol, 39'una 5 gün süreyle günde 200 mg itrakonazol verildi. İki aylık takip sonucunda flukonazol grubunda % 81,8 iyileşme, % 6 nüks; itrakonazol grubunda % 84,6 iyileşme, % 5,1 nüks saptandı. Sonuçlar istatiksel olarak anlamlı bulunmadı. Pitiriyazis versikolor tedavisinde flukonazol ve itrakonazolün yeterli ve eşit etkinlikte olduğu, ancak kısa süreli kullanımın flukonazol için bir avantaj sağlayabileceği sonucuna varıldı.