Therapeutic efficacy of topical luliconazole versus topical ketoconazole in the treatment of pityriasis versicolor patients: a hospital based comparative study
Keywords:Clinical efficacy, Gender, Luliconazole, Ketoconazole, Pityriasis versicolor
Background: To evaluate the clinical efficacy of 1% topical luliconazole versus 2% topical ketoconazole in pityriasis versicolor patients.
Methods: Mycological examination of all the pityriasis versicolor patient was done by using skin scrapings were collected from the skin lesions to prepare for 10% KOH mount, which was examined under the microscope to note the findings as KOH mount positive or negative for Malassezia fungi. KOH mount positive or negative was noted at 0 days, 2 weeks and 4 weeks continued treatments with luliconazole and ketoconazole.
Results: At the first days, majorities of patients 46 (92%) of luliconazole group were positive for KOH mount. At 14 days treatment with luliconazole, patients had 11 (22%) positive for KOH mount. At the 28 days treatment with luliconazole, only 2 (4%) patients were positive and most of the patients 49 (98%) were negative for KOH mount. Similarly, in ketoconazole group patients, 47 (94%) patients were positive for KOH mount in beginning of treatment. At 14 days treatment with ketoconazole 16 (32%) patients were positive and 34 (68%) patients were negative for KOH mount. And at the 28 days with treatment of ketoconazole 13 (26%) patients were positive and most of the patients 37 (74%) were negative for ketoconazole.
Conclusions: Male population as well as age 26-35 years were more prone for pityriasis versicolor infection. On two weeks of treatment luliconazole and ketoconazole had near about similar efficacy against pityriasis versicolor. But, on continue 4 weeks of treatment regimens topical luliconazole had more clinically efficacious than ketoconazole against pityriasis versicolor.
Borelli, D, Jacobs PH, Nall L. Tinea versicolor: Epidemiologic, clinical, and therapeutic aspects. J Am Acad Dermatol. 1991;25:300-5.
Gupta AK, Bluhm R, Summerbell R. Pityriasis versicolor. J Eur Acad Dermatol. Venereol. 2002;16,19-33.
Crespo-Erchiga, V, Florencio VD. Malassezia yeasts and pityriasis versicolor. Curr Opin Infect Dis. 2006;19:139-47.
Goslen JB, Kobayashi GS. Mycologic infections. In: Fitzpatrick TB, Eisen AZ, Wolf K, Freedberg IM, Austen KF, eds. Dermatology in General Medicine. 3rd ed. New York: McGraw Hill Book Company; 1987: 2197‑2200.
Faergemann, J. Pityrosporum species as a cause of allergy and infection. Allergy. 1999;54:413-9.
Hu SW, Bigby M. Pityriasis versicolor: A systematic review of interventions. Arch Dermatol. 2010;146:1132‑40.
Odds FC, Milne LJ, Gentles JC, Ball EH. The activity in vitro and in vivo of a new imidazole antifungal Ketoconazole. J Antimicro Chemother. 1980:6:97‑104.
Thienpont D, Van Cutsem J, Van Gerven F, Heeres J, Janssen PA. Ketoconazole ‑ a new broad spectrum orally active antimycotic. Experientia. 1979;35:606‑7.
Niwano Y, Kuzuhara N, Kodama H, Yoshida M, Miyazaki T, Yamaguchi H. In vitro and in vivo antidermatophyte activities of NND‑502, a novel optically active imidazole antimycotic agent. Antimicro Age Chemother. 1998;42:967‑70.
Uchida K, Nishiyama Y, Tanaka T, Yamaguchi H. In vitro activity of novel imidazole antifungal agent NND‑502 against Malassezia species. Int J Antimicro Age. 2003;21:234‑8.
Emmons CW. Dermatophytes: natural groupings based on the form of the spores and accessory organs. Arch. Dermatol. Syphilol. 1934;30:337-62.
Gupta AK, Sauder DN, Shear NH. Antifungal agents: An overview. Part I. J Am Acad Dermatol. 1994;30:677-98.
Crawford F, Hollis S. Topical treatments for fungal infections of the skin and nails of the foot. Cochrane Database Syst Rev. 2007;3:CD001434.
Fredriksson T. Treatment of Dermatomycoses with Topical Tioconazole and Miconazole. Dermatol. 1983;166:14-9.
Benfield P, Clissold SP. Sulconazole A Review of its Antimicrobial Activity and Therapeutic Use in Superficial Dermatomycoses. Drugs. 1988;35:143-53.
Jerajani, H, Janaki, C, Kumar S, Phiske M. Comparative assessment of the efficacy and safety of sertaconazole (2%) cream versus terbinafine cream (1%) versus luliconazole (1%) cream in patients with dermatophytoses: A pilot study. Ind J Dermatol. 2013;58:34-8.
Veraldi S, Persico MC, Schianchi R. Isoconazole nitrate vs isoconazole nitrate and diflucortolone valerate in the treatment of tinea inguinalis: Results of a multicenter retrospective study. J Drugs Dermatol. 2012;11:70-3.
Rotta I, Sanchez A, Gonçalves PR, Otuki MF, Correr CJ. Efficacy and safety of topical antifungals in the treatment of dermatomycosis: A systematic review. Br J Dermatol. 2012;166:927-33.
El-Gohary M, Van Zuuren EJ, Fedorowicz Z, Burgess H, Doney L, Stuart B, et al. Topical antifungal treatments for tinea cruris and tinea corporis. Cochrane Data Syst Rev. 2014;8:CD009992.
Khanna D, Bharti S. Luliconazole for the treatment of fungal infections: an evidence-based review. Core Evid. 2014:9.
Lange DS, Richards HM, Guarnieri J, Humeniuk JM, Savin RC, Reyes BA, et al. Ketoconazole 2% shampoo in the treatment of tinea versicolor: A multicenter, randomized, double-blind, placebo-controlled trial. J Am Acad Dermatol. 1998;39:944-50.
Rathi SK. Ketoconazole 2% shampoo in pityriasis versicolor: An open trial. Ind J Dermatol Venereol Leprol. 2003;69:142-3.
Rigopoulos D, Gregoriou S, Kontochristopoulos G, Ifantides A, Katsambas A. Flutrimazole shampoo 1% versus ketoconazole shampoo 2% in the treatment of pityriasis versicolor. A randomised double-blind comparative trial. Mycoses. 2007;50:193-5.
Aggarwal K, Jain VK, Sangwan S. Comparative study of ketoconazole versus selenium sulphide shampoo in pityriasis versicolor. Ind J Dermatol Venereol Leprol. 2003;69:86-7.
Uchida K, Nishiyama Y, Tanaka T, Yamaguchi H. In vitro activity of novel imidazole antifungal agent NND-502 against Malassezia species. Int J Antimicro Age. 2003;21:234-8.
Koga H, Nanjoh Y, Makimura K, TSsuboi R. In vitro antifungal activities of luliconazole, a new topical Imidazole. Med Mycol. 2009;47:640-7.