Abstract

BACKGROUND: Pityriasis versicolor is often found following pathologic transformation of Malassezia fungi from yeast to mycelial forms by a poorly understood mechanism and is characterized by squamous skin lesions manifesting hyper- or hypo-pigmentation. Itraconazole is a synthetic oral antifungal agent of triazole family, which acts as a selective inhibitor of the cytochrome P-450-dependent synthesis of ergosterol and is reported to demonstrate a potent antifungal efficacy against Malassezia yeasts.

OBJECT: The present clinical study was designed to evaluate the therapeutic efficacy of one- week regimen of itraconazole by studying 20 patients with pityriasis versicolor, who were diagnosed both clinically and mycologically. In addition, we wished to identify Malassezia species from skin lesions of pityriasis versicolor and examine the possible correlation of a certain Malassezia(M.) species and pityriasis versicolor.

METHODS: Twenty patients (ages, 18 to 49) were included in the study, following the diagnosis of pityriasis versicolor, which was based on clinical examinations and mycological studies (microscopy and culture). Patients received a single 200 mg dose of itraconazole (Sporanox®) capsules daily with a full meal for one week. For all patients, clinical examinations and culture and microscopic studies were done before treatment, at the end of treatment, and 4 weeks later. Scales obtained from skin lesions were studied by Parker-KOH smear examination and culture studies to identify Malassezia yeasts. Cultures were done using agar media of Leeming & Notman.

RESULTS: By comparing skin lesions before and immediately after treatment, marked improvement was observed in 7 patients (35%) and moderate improvement in 12 patients (60%) among a total of 20 patients, and 1 patient (5%) showed no response. On the other hand, by comparing skin lesions examined before treatment and 4 weeks after completing medication, complete cure was observed in 13 cases (65%), marked improvement in 5 (25%), and moderate improvement in 2 (10%). With culture studies before treatment, M. globosa, M. furfur, and M. restricta were isolated as a major fungal species in 18, 1, and 1 patients, respectively.

CONCLUSION: The result suggested that administration of a single dose of 200 mg itraconazole (Sporanox®) capsules daily for a week is a very effective treatment for pityriasis versicolor and also indicated that pityriasis versicolor is very closely related with the infection of M. globosa.

Keywords

At. globosa Itraconazole One-week regimen Pityriasis versicolor

KJMM 1999 December;4(2):124-130(7). Epub 2016 February 23
Copyright © 1999 by Korean Journal of Medical Mycology

Language

Korean/English

Author

Kyu Joong Ahn; Department of Dermatology, College of Medicine, Konkuk University, Seoul, Korea
Kyoung Jin Kim; Department of Dermatology, College of Medicine, Konkuk University, Seoul, Korea
Gil Ju Yi; Department of Dermatology, College of Medicine, Konkuk University, Seoul, Korea
Kyung Mee Yang; Janssen Korea, Ltd., Seoul, Korea

Corresponding

Kyu Joong Ahn, Department of Dermatology, College of Medicine, Konkuk University, Seoul, Korea.

Publication history

Acknowledgements

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Kyu Joong Ahn

Department of Dermatology, College of Medicine, Konkuk University, Seoul, Korea

Kyoung Jin Kim

Department of Dermatology, College of Medicine, Konkuk University, Seoul, Korea

Gil Ju Yi

Department of Dermatology, College of Medicine, Konkuk University, Seoul, Korea

Kyung Mee Yang

Janssen Korea, Ltd., Seoul, Korea

Since epub date 2016 February 23