Single-dose fluconazole versus itraconazole in pityriasis versicolor

The new antifungal triazoles itraconazole and fluconazole have revolutionized the treatment of pityriasis versicolor. Both drugs have shown promising results in different dose schedules.

To compare the efficacy and safety of single oral dose treatment with fluconazole versus itraconazole in patients with pityriasis versicolor.

A total of 40 patients with pityriasis versicolor were allocated randomly to group A and group B. A single dose of fluconazole (400 mg) or itraconazole (400 mg) was given orally to group A or group B patients, respectively. Patients were assessed mycologically by KOH and culture. Culture was done from lesional and perilesional skin to quantify growth and to observe the effect of these drugs and the persistence/reappearance of the fungus in relation to relapse at 2 and 8 weeks. Relapse was defined as reappearance or worsening of clinical signs and symptoms or positive KOH/culture after initial improvement.

Thirteen (65%) patients in the fluconazole group and 4 (20%) patients in the itraconazole group became culture negative at the end of 8 weeks. Relapse was found to be higher in the itraconazole group compared to the fluconazole group (60 vs. 35%). A direct correlation was found between the relapse rate and positivity of perilesional skin for Malassezia furfur.

In the same dosing, fluconazole was found to be more effective than itraconazole; however, both drugs were found to be safe.