News Forum: Flutrimazole v ketoconazole for pityriasis versicolor

GPs with an interest in dermatology review the latest papers of significance from research teams across the world

Rigopoulos D, Gregoriou S, Kontochristopoulos G et al. Mycoses 2007;50(3):193-5

This trial, based in Greece, was designed to look at the use of flutrimazole 1% shampoo versus ketoconazole 2% shampoo in a head-to-head comparison of efficacy, safety and tolerability when treating pityriasis versicolor.

This was a small study of 60 patients with pityriasis versicolor, diagnosed clinically and confirmed with direct microscopy and culture. Patients were randomly allocated to two treatment groups, one receiving flutrimazole, the other, ketoconazole. This was performed using double-blind methods to avoid bias.

Each group was asked to apply the solution on the head and body for a 14-day course. After this, the skin was evaluated clinically and with the use of repeat microscopy and culture, and the patients were asked to comment on the treatment.

In the ketoconazole group, 80.8 per cent had visual resolution and negative mycological findings. In the flutrimazole group, 75.9 per cent had visual resolution and negative mycological findings.

The difference in the two treatments was found to be non-significant statistically.

There were no reported adverse effects in either group. As for patient preference, flutrimazole was viewed more favourably, with 79 per cent finding it acceptable in terms of texture, smell and foaming, compared to 53 per cent favouring ketoconazole.

The authors concluded that flutrimazole appears as effective and safe as ketoconazole. This sounds like a potential option for the treatment of pityriasis versicolor and with patient satisfaction appearing positive, can only be a good thing. The question is, will we see larger studies supporting its use, will it be available on theNHS and how much is it going to cost?

- Dr Jane Barnard, GP with an interest in dermatology in Yateley, Hampshire

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