Treatment and Prophylaxis of Pityriasis Versicolor with Oral Fluconazole

Treatment with oral antifungals is usually preferred when pityriasis versicolor (PV) affects large body surface areas, especially in chronic or recurrent cases. In this study, we evaluated the effectiveness of fluconazole in the treatment and prophylaxis of patients with chronic or recurrent, mostly extensive, PV. Treatment regimen consisted of fluconazole 100mg once daily for 10 consecutive days; 3–4 weeks after the end of treatment, patients were evaluated for clinical and mycological response (visit T1). Patients with mycological eradication received fluconazole 200mg/day (100mg twice a day) for two consecutive days per month for 5 months. Clinical and mycological evaluations were performed after 2 months (T2) and 5 months (T3) from visit T1. Mycological efficacy was assessed using microscopic examination and represented the primary efficacy parameter; therefore, positive microscopy at any visit was reason for withdrawal from the study. At visit T1 60 subjects were evaluated; most patients (94 %) were clinically cured or improved. Similar clinical response rates were observed at visits T2 and T3. The proportion of patients with eradication of Malassezia was 92 % at T1 visit, 88 % at T2 visit, and 91 % at T3 visit. No relevant adverse events occurred. The results of this open preliminary study suggest that an oral treatment with fluconazole 100mg/day for 10 days is effective in PV. A maintenance monthly treatment with fluconazole 200mg/day for two consecutive days can be very useful to prevent recurrence of PV