Wahab M A, Kamal S B, Shahin M R, Siddique R U, Hassan M R, Hassan B S, Kumar S B, Haque A R, Nandi A K, Das P K
Professor Lt Col Md Abdul Wahab, Professor, Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2020 Apr;29(2):351-356.
Pityriasis versicolor (PV) also known as tinea versicolor, which is chronic and superficial fungal skin disease caused by Malassezia yeasts. A permanent cure may difficult to achieve and this may explain the long-term nature of the disease. Consequently, a preventive treatment regimen may help to prevent the recurrence of pityriasis versicolor. Whether, the recurrence of tinea versicolor could be prevented by monthly itraconazole treatment regimen after a short course of itraconazole therapy. Open treatment followed by a randomized, single blind placebo control trial. Multi-center trial was characterized by an open, active treatment phase with itraconazole followed by a randomized placebo controlled treatment for prevention of recurrence. A total 200 patients (150 male and 50 female) were included in this study and was given 200mg itraconazole daily for 7 days (treatment phase). Patients in whom tinea versicolor was mycologically cured divided into Group A and Group B. Active open treatment was followed by preventive itraconazole treatment 200mg twice daily in Group A and placebo in Group B monthly for 6 consecutive months. The patients were diagnosed clinically and confirmed by Wood's lamp examination and KOH microscopy. Clinical improvement in 90%, negative Wood's lamp examination in 86.5% and Mycological cure in 85.5% were found at the end of open treatment. The mycological cure, 171 subjects were taken into this study for preventive treatment phase and divided into two groups- Group A & Group B. Preventive treatment was given in Group A and placebo in Group B. After the preventive treatment, the end point (After 6 months), clinical improvement, negative Wood's lamp examination and mycological cure were found in 81(90%), 76(84.4%) and 75(83.3%) in Group A and 44(55%), 41(51.3%) and 42(52.5%) in Group B respectively. In preventive treatment phase, 1 patient in Group A did not complete the study. No patient experienced any serious adverse effects. Prevention of recurrence of Pityriasis versicolor with itraconazole is as effective as treatment.
花斑糠疹（PV）也称为花斑癣，是由马拉色菌酵母引起的慢性浅表真菌性皮肤病。可能难以实现永久性治愈，这或许可以解释该疾病的长期性。因此，预防性治疗方案可能有助于预防花斑糠疹的复发。短疗程伊曲康唑治疗后，每月使用伊曲康唑治疗方案是否能预防花斑癣的复发。采用开放治疗，随后进行随机、单盲安慰剂对照试验。多中心试验的特点是有一个使用伊曲康唑的开放、积极治疗阶段，随后是用于预防复发的随机安慰剂对照治疗。本研究共纳入200例患者（150例男性和50例女性），并给予每日200mg伊曲康唑，共7天（治疗阶段）。花斑癣在真菌学上治愈的患者分为A组和B组。A组在积极的开放治疗后，给予预防性伊曲康唑治疗，每日200mg，分两次服用，B组每月服用安慰剂，连续6个月。患者通过临床诊断，并经伍德灯检查和氢氧化钾显微镜检查确诊。开放治疗结束时，发现临床改善率为90%，伍德灯检查阴性率为86.5%，真菌学治愈率为85.5%。在真菌学治愈的患者中，171名受试者进入预防性治疗阶段，并分为两组——A组和B组。A组给予预防性治疗，B组给予安慰剂。预防性治疗后，终点（6个月后），A组临床改善、伍德灯检查阴性和真菌学治愈的患者分别为81例（90%）、76例（84.4%）和75例（83.3%），B组分别为44例（55%）、41例（51.3%）和42例（52.5%）。在预防性治疗阶段，A组有1例患者未完成研究。没有患者出现任何严重不良反应。伊曲康唑预防花斑糠疹复发的效果与治疗效果相同。
