Treatment of pityriasis capitis (dandruff) with econazole nitrate.

63 patients of both sexes with pityriasis sicca or steatoides were examined for presence of Pityrosporum ovale on the scalp. Only those cases in which very numerous yeasts were seen in all squamae present in the preparation were considered positive. According to the severity or duration of pityriasis, 60% of the patients in this population represented severe cases and 38% refractory cases. A solution of econazole nitrate was applied as a spray, morning and evening, for a period of 10 to 20 days (mean). The overall assessment of the clinical effects of econazole nitrate indicated 56 favourable results, with complete disappearance of objective clinical signs in 47 cases; the course of pruritus proceeded roughly parallel with that of the objective signs. The mycological checking of the clinical results, performed at least 7 days after the conclusion of therapy, disclosed 6 failures and 57 successes. In 17 patients, the microscopic examination of squamae was complemented by culture before and after treatment: in all cases, the culture, positive before econazole nitrate therapy, became negative after treatment, thus confirming the results of direct examination. These data suggest that Pityrosporum ovale plays a pathogenetic part in pityriasis simplex capitis.