Randomized comparative clinical trial of itraconazole and selenium sulfide shampoo for the treatment of pityriasis versicolor

Forty patients with pityriasis versicolor, fluorescence of involved areas under Wood's light, and positive microscopic identification of Malassezia furfur were randomly assigned to treatment with either oral itraconazole (200 mg once daily for five consecutive days) or 2.5% selenium sulfide shampoo (once daily application for seven days). Each treatment group consisted of 20 patients. On assessment three weeks after the end of treatment, all patients given itraconazole showed a response: 17 were healed, and three had mild residual lesions. Likewise, all patients in the selenium sulfide group responded to therapy: 16 were healed, and four had mild residual lesions. Tolerability, acceptability, and compliance were excellent with itraconazole. All 20 patients given the drug stated a preference for oral treatment. In the selenium sulfide group, five patients (25%) had adverse reactions attributable to the medication; one of these patients experienced an irritation severe enough to warrant the discontinuation of treatment on the third day. Ten patients in this group stated a preference for oral treatment.