A randomized controlled trial of combination treatment with ketoconazole 2% cream and adapalene 0.1% gel in pityriasis versicolor

Shi, Tian-Wei; Jiang-an, Zhang; Tang, Yong-Bo; Yu, Hongxing; Li, Zhanguo

doi:10.3109/09546634.2014.921661

Cited by 17 publications

(12 citation statements)

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“…Dermatophytoses are usually associated with several-fold increase in epidermal cell proliferation, leading to epidermal thickening with hyperkeratosis and scaling of the skin [ 47 ]. As scales impede the absorption of topical antifungal drugs, the sole use of topical antifungal agents may be ineffective, especially in recalcitrant cases [ 48 ]. Keratolytics, by their dual effect, can help in increasing levels of topical antifungals, and removing the stratum corneum where fungi lie [ 30 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

Expert Consensus on The Management of Dermatophytosis in India (ECTODERM India)

et al. 2018

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BackgroundDermatophytosis management has become an important public health issue, with a large void in research in the area of disease pathophysiology and management. Current treatment recommendations appear to lose their relevance in the current clinical scenario. The objective of the current consensus was to provide an experience-driven approach regarding the diagnosis and management of tinea corporis, cruris and pedis.MethodsEleven experts in the field of clinical dermatology and mycology participated in the modified Delphi process consisting of two workshops and five rounds of questionnaires, elaborating definitions, diagnosis and management. Panel members were asked to mark “agree” or “disagree” beside each statement, and provide comments. More than 75% of concordance in response was set to reach the consensus.ResultKOH mount microscopy was recommended as a point of care testing. Fungal culture was recommended in chronic, recurrent, relapse, recalcitrant and multisite tinea cases. Topical monotherapy was recommended for naïve tinea cruris and corporis (localised) cases, while a combination of systemic and topical antifungals was recommended for naïve and recalcitrant tinea pedis, extensive lesions of corporis and recalcitrant cases of cruris and corporis. Because of the anti-inflammatory, antibacterial and broad spectrum activity, topical azoles should be preferred. Terbinafine and itraconazole should be the preferred systemic drugs. Minimum duration of treatment should be 2–4 weeks in naïve cases and > 4 weeks in recalcitrant cases. Topical corticosteroid use in the clinical practice of tinea management was strongly discouraged.ConclusionThis consensus guideline will help to standardise care, provide guidance on the management, and assist in clinical decision-making for healthcare professionals.

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Section: Discussionmentioning

confidence: 99%

Expert Consensus on The Management of Dermatophytosis in India (ECTODERM India)

et al. 2018

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“…Treatment efficacy of topical formulations may be lower in more tropical climates [ 27 ]. Recent work demonstrating the efficacy of combination topical treatment [ 22 ] may provide an alternative treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, a combination of ketoconazole cream with 0.1% adapalene gel was compared to ketoconazole cream alone in a double blind, randomized clinical trial [ 22 ]. Adapalene gel is a derivative of naphthoic acid used to treat acne that acts by inhibiting cellular differentiation [ 29 ].…”

Section: Topical Treatment For Pityriasis Versicolormentioning

confidence: 99%

“…Combination treatment produced clinical improvement and mycological cure faster (within 2 weeks) than monotherapy. By week 4, the treatment with the combination of ketoconazole and adapalene produced significantly greater clinical improvement and mycological cure as compared to ketoconazole monotherapy (92% vs. 72%, p = 0.009) [ 22 ]. Mild adverse events were reported in treatment groups and included erythema, skin dryness, and burning sensation with the combination treatment or mild irritation with monotherapy [ 22 ].…”

Section: Topical Treatment For Pityriasis Versicolormentioning

confidence: 99%

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Antifungal Treatment for Pityriasis Versicolor

Gupta

Foley

2015

JoF

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Background: Pityriasis versicolor (PV), also known as tinea versicolor, is caused by Malassezia species. This condition is one of the most common superficial fungal infections worldwide, particularly in tropical climates. PV is difficult to cure and the chances for relapse or recurrent infections are high due to the presence of Malassezia in the normal skin flora. This review focuses on the clinical evidence supporting the efficacy of antifungal treatment for PV. Method: A systematic review of literature from the PubMed database was conducted up to 30 September 2014. The search criteria were “(pityriasis versicolor OR tinea versicolor) AND treatment”, with full text available and English language required. Conclusions: Topical antifungal medications are the first-line treatment for PV, including zinc pyrithione, ketoconazole, and terbinafine. In cases of severe or recalcitrant PV, the oral antifungal medications itraconazole and fluconazole may be more appropriate, with pramiconazole a possible future option. Oral terbinafine is not effective in treating PV and oral ketoconazole should no longer be prescribed. Maintenance, or prophylactic, therapy may be useful in preventing recurrent infection; however, at this time, there is limited research evaluating the efficacy of prophylactic antifungal treatment.

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“…According to Di Fonzo [3], the cure rate was observed in 100% of patients after 2 weeks of ketoconazole shampoo 1% and 2%. It was 81%, 55% and 72% in Rigoponlos (2007), Cantrell (2014) and Shi (2014)’s study [6], [7], [8].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Azole Antifungal in Treatment of Pityriasis Versicolor

Cam¹,

Van²,

Hau³

et al. 2019

Open Access Maced J Med Sci

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AIM:Compare itraconazole alone, fluconazole combined with ketoconazole and ketoconazole in the treatment of patients with pityriasis versicolor.MATERIAL AND METHODS:A group of 240 pityriasis versicolor patients (confirmed with KOH and culture) were classified into 3 groups: Fluconazole 300 mg a week and 2% ketoconazole foam twice a week for 2 weeks (Category I), Itraconazole 200 mg daily for one week (category II); Ketoconazole 2% foam daily for 2 weeks (Category 3). Clinical (colour of macule, scale, pruritus) and mycological assessment were done after 4 weeks of therapy.RESULTS:After 4 weeks of treatment, clinical cure was observed in 62.4% (Category I), 36.3% (Category II) and 37.5% (Category III).CONCLUSION:It was reported in our study that the most effective regimen for PV patients is fluconazole 300 mg per week combined with ketoconazole 2% twice a week for 2 weeks.

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A randomized controlled trial of combination treatment with ketoconazole 2% cream and adapalene 0.1% gel in pityriasis versicolor

Abstract: The combination of adapalene 0.1% gel and ketoconazole 2% cream is effective and safe in the treatment of pityriasis versicolor. This therapeutic regimen was rapid, providing a valuable option for patients with pityriasis versicolor.

Cited by 17 publications

References 10 publications

Expert Consensus on The Management of Dermatophytosis in India (ECTODERM India)

Expert Consensus on The Management of Dermatophytosis in India (ECTODERM India)

Antifungal Treatment for Pityriasis Versicolor

Efficacy of Azole Antifungal in Treatment of Pityriasis Versicolor

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