Prophylactic itraconazole prevents pityriasis versicolor recurrence

NEW YORK (Reuters Health) – Once-a-month treatment with itraconazole is effective in preventing recurrence of pityriasis (or tinea) versicolor following initially successful treatment, according to results of a multicenter, multinational study.

Dr. Jan Faergemann, of Sahlgrenska University Hospital in Gothenburg, Sweden, and associates treated 223 patients for 1 week with itraconazole 200 mg q.d. As they report in the Archives of Dermatology for January, 92% of those treated were considered cured based on the absence of hyphae on the skin.

The 205 cured patients were randomly assigned to placebo or prophylactic treatment of itraconazole 200 mg b.i.d. on 1 day per month for 6 consecutive months. Significantly more of those in the treatment group than in the placebo group remained mycologically negative over the course of the trial, 88% versus 57% (p < 0.001). Erythema, hypopigmentation, desquamation and itching also improved more in the treatment group.

Mild to moderate adverse events considered at least possibly related to itraconazole were reported by 10 patients during the initial week of treatment and by two during the prophylactic phase. Only one case of moderate urticaria leading to study withdrawal was considered very likely to be related to the medication.

Dr. Faergemann's group notes that recurrence of pityriasis versicolor has been recorded at levels of up to 60% in 1 year and 80% in 2 years. They conclude that their prophylactic treatment regimen was safe, effective and associated with high patient compliance.

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