Therapeutic Efficacy of Different Azole Antifungal Regimens in Treatment of Tinea Versicolor

Systemic antifungal are used in severe tinea versicolor or in cases not responding to topical therapy, different regimen modalities with different efficacy result and cure rates have been tried in this experiment. To compare different modalities regimens of the azoles group in the treatment of tinea versicolor. This study was carried out in Department of dermatology and venereology in AL –KINDY teaching Hospital in Baghdad during the Period between May 2006May 2009. One hundred seventeen Patients complaining of tinea versicolor were assessed and randomized into six groups:1 group was given Itraconazole 400 mg single dose (n=20); 2 group was given Itraconazole 200 mg /day for one week (n=19); 3 group was given Fluconazole 300 mg single dose (n = 20); 4 group was given Fluconazole extended regimen 150 mg weekly for four weeks(n=19); 5 group was given Ketoconazole 400 mg single dose (n=19); 6 group was given Ketoconazole 200 mg daily for 10 days (n=20). The response was assessed after 2 weeks and 6 weeks of follow up. The patients who did not respond to treatment regimen during the first 2 weeks were followed for another 4 weeks and were evaluated again for their response. After 2 weeks of treatment the highest rate (52.6%) was observed in the Itraconazole extended regimen group, while (35%) was observed in the Fluconazole single dose regimen, Response rate for nonrespondents at 2 weeks after another 4 weeks of follow up show highest 55.6 % for Itraconazole extended regimen and lowest 23.1% for Fluconazole single dose, Response rate after 6 weeks of follow up was highest 78.9% for Itraconazole extended regimen, and lowest 35% for Fluconazole single dose regimen. Relapse of a previously cured skin lesion after 6 weeks was 42.9% for Fluconazole single dose and zero% for the Itraconazole and fluconazole extended regime. Different regimens of systemic azole are used for treatment of pityriasis versicolor both for a single and extended dose regimens. All were found to be effective in different success rates. Single and extended regimen of itraconazole showed the highest response figure in this experiment.