Korean J Dermatol.  2021 Jun;59(5):370-378.

Comparison of the Efficacy of Oral Azoles in Pityriasis Versicolor: A Systematic Review and Meta-Analysis

• Kwon R
• Lee SH
• Park YL
• Lee SH

Abstract

Background
In pityriasis versicolor, systemic antifungal agents may be indicated for widespread or refractory lesions rather than topical treatment. Oral ketoconazole is an effective treatment for pityriasis versicolor. To our knowledge, this is the first meta-analysis to compare antifungal agents one-to-one.
Objective
To compare the effectiveness of oral azole antifungal agents (fluconazole, itraconazole, and ketoconazole) one-to-one in pityriasis versicolor.
Methods
A computerized search was performed in different databases, including PubMed, Cochrane, EMBASE, OVID Medline, KoreaMed, KISS, and MedRIC. Seven randomized controlled trials were included. Further, statistical analyses of the extracted outcome data from the studies were performed using Rex Software (ver. 3.0.1).
Results
A total of 1,828 records were identified. The results of the meta-analysis including seven studies revealed no significant differences in the mycological cure rates between fluconazole and ketoconazole (risk ratio [RR]: 1.01, 95% confidence interval [CI]: 0.93∼1.09, p=0.8246), fluconazole and itraconazole (RR: 1.14, 95% CI: 0.81∼1.60, p=0.4512), and ketoconazole and itraconazole (RR: 1.07, 95% CI: 0.96∼1.20, p=0.2265).
Conclusion
There was no superiority in the therapeutic effect of any drug among the oral azole antifungals used in pityriasis versicolor.

Keyword

Antifulgal agents; Azoles; Fluconazole; Itraconazole; Ketoconazole; Tinea versicolor