Comparison of Topical ketoconzole alone versus Topical Ketoconazole plus Topical Adapalene in the Treatment of Patients with Pityriasis Versicolor

Background& Objectives: Pityriasis Versicolor (PV) is a chronic cutaneous fungal infection caused by Malassezia species. A recent study showed combination therapy consisting of Ketoconazole plus Adapalene gel to be superior to Ketoconazole monotherapy. The objective of this study was to compare the frequency of patients improved with Ketoconazole alone versus Ketoconazole plus Adapalene in the treatment of Pityriasis Versicolor. Study design: Randomized controlled trial. Place & duration of study: Department of Dermatology, CMH Lahore from 20th May 2016 to 19th November 2016. Methods: This study included 80 patients, both male and female, aged between 18 -70 yrs presenting with Pityriasis Versicolor. These patients were divided into two treatment groups. Randomly Patients in Group-A were given Ketoconazole cream alone while patients in GroupB were given combination therapy with Ketoconazole cream plus Adapalene gel applied separately with different timings. Outcome variable was number of patients improved after 2 weeks of treatment. Results: The frequency of improvement at 2 weeks was significantly higher with the combination therapy (87.5% vs. 47.5%; p=0.000) as compared to Ketoconazole alone and this difference was significant across all age, gender and duration of disease groups. Conclusion: The frequency of improvement was significantly higher with the combination therapy consisting of Ketoconazole plus Adapalene as compared to Ketoconazole alone, advocating preferred use of combination therapy in patients presenting with Pityriasis Versicolor in future practice