Antifungal Treatment for Pityriasis Versicolor

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Aditya K Gupta1,2, Kelly A Foley3

  • 1Department of Medicine, University of Toronto, Toronto, ON M5G 2C4, Canada. agupta@execulink.com.

Journal of Fungi (Basel, Switzerland)
|January 30, 2018
PubMed
Abstract

Insights

Topical antifungals like zinc pyrithione, ketoconazole, and terbinafine are effective first-line treatments for pityriasis versicolor (PV). Oral antifungals are reserved for severe cases, but oral terbinafine is not recommended for PV.

Area of Science:

  • Dermatology
  • Mycology
  • Infectious Diseases

Background:

  • Pityriasis versicolor (PV), or tinea versicolor, is a common superficial fungal infection caused by Malassezia species.
  • PV is prevalent globally, especially in tropical regions, and is characterized by high recurrence rates due to Malassezia's presence in normal skin flora.
  • This review evaluates clinical evidence for antifungal treatments in managing PV.

Purpose of the Study:

  • To systematically review the clinical evidence supporting the efficacy of antifungal treatments for pityriasis versicolor (PV).

Main Methods:

  • A systematic literature review was performed using the PubMed database up to September 30, 2014.
  • Search terms included "pityriasis versicolor" or "tinea versicolor" combined with "treatment".
  • Inclusion criteria required full-text availability and English language.

Main Results:

  • Topical antifungal agents such as zinc pyrithione, ketoconazole, and terbinafine are recommended as first-line treatments for PV.
  • For severe or resistant PV, oral itraconazole and fluconazole are effective options, with pramiconazole noted as a potential future treatment.
  • Oral terbinafine has demonstrated ineffectiveness for PV, and oral ketoconazole is no longer advised.

Conclusions:

  • Topical antifungals are the primary treatment for pityriasis versicolor.
  • Oral antifungals are indicated for severe or recalcitrant cases, with specific agents recommended and others discouraged.
  • Prophylactic antifungal therapy may help prevent recurrence, though further research is needed to establish its efficacy.
Keywords:
Malasseziaketoconazoleoral antifungalstinea versicolortopical antifungals

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