Comparision between therapeutic efficacy of terbinafine and ketoconazole in Tinea versicolor

Background and Objective: Tinea versicolor is a common fungal infection of the skin caused by the dimorphic lipophilic yeast Pityrosporum orbicular (Malassezia furfur). Lesions begin as multiple small, circular macules of various colors. The upper trunk is most commonly affected due to the side effects of oral treatment and drug resistance, this study was done to compare the therapeutic efficacy of topical terbinafine versus topical ketoconazole in Tinea versicolor. Materials and Methods: This Randomized double blind clinical trial study was conducted between 2008-09. Sixty nine patients with a clinical diagnosis of pityriasis versicolor confirmed by microscopic potassium hydroxide (KOH) examination were taken for the study. Patients randomly divided into 2 treatment groups: 35 patients in terbinafine group, treated by terbinafine 1% once daily for 2 weeks and 34 patients in ketoconazole group, treated with ketoconazole 2% once daily for 2 weeks. Five patients of terbinafine and 4 patients of ketoconazole groups were excluded due to lack of follow-up. Patients were followed up at monthly intervals for 3 months and recurrence and cure rate for each subject were recorded. Data was analyzed by SPSS-16, t student and Chi-Square test. Results: The mean moderate cure rate obtained one month after treatment was 20% in terbinafine group versus 3.3% in ketoconazole group, and there was no any significant difference between two groups. The mean moderate cure rate two month after treatment was 67.7% in terbinafine group and 60% in ketoconazole group (P<0.05). The mean complete cure rate three month after treatment was 73.3% in terbinafine group and 10% in ketoconazole group (P<0.05). The percent of positive KOH examination, three month after treatment was 10% in terbinafine group and 36.7% in ketoconazole group (P<0.05). Conclusion: This study showed that terbinafin is more effective than ketoconazole in treatment of tinea versicolor.