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Solid lipid nanoparticles (SLNs) are very potential formulations for topical delivery of antifungal drugs. Hence, the purpose of this research was to formulate the well-known antifungal agent Fluconazole (FLZ)-loaded SLNs topical gel to improve its efficiency for treatment of Pityriasis Versicolor (PV). FLZ-SLNs were prepared by modified high shear homogenization and ultrasonication method using different concentration of solid lipid (Compritol 888 ATO, Precirol ATO5) and surfactant (Cremophor RH40, Poloxamer 407). The physicochemical properties and the in vitro release study for all FLZ-SLNs were investigated. Furthermore, the optimized FLZ-SLN formula was incorporated into gel using Carpobol 934. A randomized controlled clinical trial (RCT) of potential batches was carried out on 30 well diagnosed PV patients comparing to market product Candistan® 1% cream. Follow up was done for 4 weeks by clinical and KOH examinations. The results showed that FlZ-SLNs were almost spherical shape having colloidal sizes with no aggregation. The drug entrapment efficiency ranged from 55.49% to 83.04%. The zeta potential values lie between −21 and −33 mV presenting good stability. FLZ showed prolonged in vitro release from SLNs dispersion and its Carbapol gel following Higuchi order equation. Clinical studies registered significant improvement (p < .05) in therapeutic response (1.4-fold; healing%, 4-fold; complete eradication) in terms of clinical cure and mycological cure rate from PV against marketed cream. Findings of the study suggest that the developed FLZ loaded SLNs topical gels have superior significant fast therapeutic index in treatment of PV over commercially available Candistan® cream. [ABSTRACT FROM AUTHOR]

Purpose: In the previous studies, positive effect of sunlight on seborrheic dermatitis may well be explained by the direct influence of UV-light on the yeasts. Narrow-band ultraviolet-B phototherapy appears to be a very effective and safe treatment option for patients with severe seborrheic dermatitis. We aimed to investigate the efficacy of narrow-band ultraviolet-B phototherapy as an alternative treatment for pityriasis versicolor. Material and methods: A total of 38 patients diagnosed with disseminated pityriasis versicolor having more than four relapsing episodes within 12 months were treated with narrow-band ultraviolet-B phototherapy given three times weekly. Clinical assessment on the basis of the severity of pruritus, erythema/hyperpigmentation and scaling and mycological examination were made at Weeks 0, 4, 8, 12 and 16. Results: Of the remaining 30 patients, 20 (66.7%) achieved excellent results and four patients (14%) had mild residual disease. The decrease in the clinical scores calculated at 4th week, 8th week, 12th week and 16th week were statistically significant. Conclusion: Narrow-band ultraviolet-B presumably may have an immunomodulatory and inhibitory effect on Malassezia growth. Narrowband ultraviolet-B is an effective and safe alternative tool for the management of extensive and recurrent pityriasis versicolor for patients who are unresponsive to conventional treatments. [ABSTRACT FROM AUTHOR]

Background: Treatment of alopecia areata (AA) involves use of high potency topical corticosteroids under occlusion that, even very effective, can lead to several adverse effects. Objective: We report 10 cases of patients with AA that, after using high potency topical corticosteroids, have developed tinea versicolor of the neck area. Methods: Ten patients with AA, aged 18–38 years, were prescribed with clobetasone propionate 0.05% cream under occlusion every other day but, after 3–4 months of treatment, they returned to our facility complaining the appearance of multiple white or red-brown round or oval macules in the neck area. Results: Diagnosis of pityriasis versicolor was confirmed by direct microscopy examination of skin scrapings in 10% potassion hydroxide (KOH) solution. All patients received systemic antifungal therapy associated with the daily use of ketoconazole shampoo. Conclusion: Tinea versicolor of the neck should be included among a rare but possible side effect of prolonged application of high potency topical steroids on the scalp. These cases reinforce the importance of careful dermatologic examination and recommend preventive measures in patients with alopecia areata that are using these drugs. [ABSTRACT FROM AUTHOR]

Background: Ketoconazole cream and adapalene gel are effective drugs against pityriasis versicolor. However, there are no reports on combination treatment with both compounds in pityriasis versicolor. Objective: To evaluate the efficacy and safety of combination therapy with adapalene 0.1% gel and ketoconazole 2% cream against pityriasis versicolor. Methods: Participants with pityriasis versicolor were randomly assigned to two groups: the combination group was treated with adapalene 0.1% gel and ketoconazole 2% cream once daily, and the monotherapy group received ketoconazole 2% cream twice daily. The treatment lasted 2 weeks in both groups. Outcomes were assessed at baseline and 1, 2 and 4 weeks after the initiation of treatment. Results: We noted clinically significant differences in total improvement rates between groups Weeks 1 and 2. A statistically significant difference was obtained Week 4. The treatment was well tolerated by all participants. Conclusions: The combination of adapalene 0.1% gel and ketoconazole 2% cream is effective and safe in the treatment of pityriasis versicolor. This therapeutic regimen was rapid, providing a valuable option for patients with pityriasis versicolor. [ABSTRACT FROM AUTHOR]

BACKGROUND: A number of effective topical therapies are available for the treatment of tinea versicolor (TV). However, topical antifungals are difficult to apply to a large body surface area and for this reason TV is perhaps more easily treated with systemic agents. METHODS: A total of 128 patients with TV, aged 15-55 years, were entered into a randomized, double-blind, clinical trial comparing the efficacy and tolerance of two regimens of oral treatment for TV. The patients were randomly divided in two groups: group 1 received two 150 mg capsules of fluconazole in a single dose repeated weekly for 2 weeks; and group 2 received two 200 mg tablets of ketoconazole in a single dose repeated weekly for 2 weeks. Diagnosis of TV was made clinically by direct KOH preparation and Wood's lamp examination. RESULTS: Of 128 patients, 100 completed the study and no major side-effects were noted between the two treatment regimens. Results of the study showed no significant differences in efficacy, safety and tolerability between the two treatment regimens. The maximal cure rate was achieved at 8 weeks from the start of treatment and decreased slightly afterwards. CONCLUSIONS: Fluconazole and ketoconazole demonstrated similar efficacy in the treatment of TV. We also demonstrated a lack of correlation between mycological cure and hypopigmentation at the end of treatment (2 weeks) and the usefulness of Wood's lamp examination in detecting cure of TV. [ABSTRACT FROM AUTHOR]

Tinea versicolor is a chronic superficial infection of the skin, caused by Malassezia furfur. The disease is recurrent and. hard to eradicate with topical antifungal agents. In this study we compared the efficacy, safety and tolerability of three regimens of oral treatment for tinea versicolor: itraconazole 200 mg/day for 1 week, itraconazoie 100 mg/ day for 2 weeks and ketoconazole 800 mg in 2 weekly doses of 400 mg. We randomly assigned 105 patients With extensive tinea versicolor to receive each of the three regimens and followed the patients for 16 weeks (a longer period than usual), At every visit, we checked the presence of tinea versicolor by direct K0H preparation and Wood's lamp, and the presence of signs and symptoms of infection were recorded. Of the 105 patients, 89 completed the study, and no major side-effects were noted with any of the treatment regimens. Our results show that there were no significant differences in efficacy (cure rate), safety and tolerability between the three treatment regimens. The maximal cure rate was achieved after 8 weeks from the start of treatment and decreased slightly afterwards. We also demonstrated a lack of correlation between mycological cure and hypopigmentation at the end of treatment (2 weeks) and the usefulness of Wood's lamp examination in detecting cure of' tinea versicolor. [ABSTRACT FROM AUTHOR]

BACKGROUND: Tinea (pityriasis) versicolor is a superficial infection of the stratum corneum by the lipophilic fungus known as Malassezia furfur. OBJECTIVE: To evaluate the efficacy and safety of a 400 mg single dose or 7-day 200 mg daily dose of itraconazole capsules in the treatment of mycologically confirmed pityriasis versicolor. METHODS: A total of 50 patients were entered into a randomized, open, clinical trial comparing a 400 mg single dose (n = 24 for group 1) with a 7-day 200 mg daily dose (n = 26 for group 2) of itraconazole. Clinical signs and symptoms and mycologic evaluation (potassium hydroxide preparation and Wood's lamp) were performed before treatment, and at weeks 3 and 6 after treatment. RESULTS: Both regimens of itraconazole were effective. Our results showed that there were no significant differences in efficacy and safety between the two treatment regimens (chi-square tests, p > 0.05). CONCLUSIONS: On the basis of these findings, a single dose of itraconazole 400 mg/day was as effective as the 7-day 200 mg daily dose in the treatment of pityriasis versicolor. [ABSTRACT FROM AUTHOR]

Itraconazole is one of the systemic treatment options for extensive tinea versicolor. A male patient who developed thrombocytopenia during the treatment of tinea versicolor by itraconazole is reported in this manuscript. He was diagnosed to develop thrombocytopenia on the third day of treatment. In the literature, there are two reports of itraconazole-induced thrombocytopenia both in malignancy patients. One report contained three patients who developed thrombocytopenia as a result of a drug interaction between bortezomib and itraconazole. The other report contained a patient who developed thrombocytopenia following six weeks of treatment with itraconazole. It is hypothesized by the author of this manuscript that this patient’s thrombocytopenia developed as a result of selective bone marrow suppression which is brought about by itraconazole’s effect on megakaryocytes. [ABSTRACT FROM AUTHOR]

A correction to the article related to the formulation and clinical study of fluconazole-loaded solid lipid nanoparticles topical gel for the treatment of pityriasis versicolor is presented.

A correction to the article "Fluconazole-loaded solid lipid nanoparticles topical gel for treatment of pityriasis versicolor: formulation and clinical study" which appeared in the previous issue, is presented.