Tuba AKI, Muammer EŞREFOĞLU, Yelda KARINCAOĞLU, Hamdi ÖZCAN

Tinea versikolor tedavisinde itrakonazol ve itrakonazol ile birlikte uygulanan %2 ketokonazol şampuanın etkinliğinin karşılaştırılması. Retrospektif çalışma

Tinea versikolor lipofilik bir maya olan Malassezia furfur'un neden olduğu sık rastlanılan yüzeyel bir mantar infeksiyonudur. Tinea versikolorda tedavi seçenekleri arasında topikal ketokonazol şampuan ve sistemik itrakonazol yer almaktadır. Çalışmamızda tek başına kullanılan itrakonazol ile itrakonazol ve %2 lik ketokonazol şampuanın birlikte uygulamalarının tedavideki etkinliklerinin retrospektif olarak değerlendirilmesi amaçlandı. Materyal-Metod: Polikliğimize 1998-2002 yılları arasında başvuran ve tinea versikolor tanısı konulan hastaların dosyaları incelendi. Tedavisinde sadece itrakonazol ve itrakonazol ile birlikte ketokonazol %2 şampuan kullanılan yaygın tutulumlu olgular çalışmaya alındı. Bulgular: Çalışma grubu 29 (%56.9) erkek, 22 (%43.1) bayan toplam 51 olgudan oluştu. Hastaların 32 (%62.7'si itrakonazol, 19 (%37.3)'u itrakonazol ile birlikte ketokonazol %2 şampuan kullanmıştı. Sadece itrakonazol kullanan olguların 21 (%65.6)'in tedaviye yanıt verdiği, 11 (%34.4)'in tedaviye yanıt vermediği, itrakonazol ile birlikte ketokonazol şampuan kullanan grupta ise bu oranların sırasıyla 17 (%89.5) ve 2 (%10.5) olduğu belirlendi. Veriler istatistiksel olarak değerlendirildiğinde her iki tedavi yöntemi arasında anlamlı fark olmadığı tespit edildi. Sonuç: Çalışmamızda itrakonazol ile birlikte ketakonazol şampuan kullanan grupta iyileşme oranı yüksek olmakla birlikte istatistiksel fark anlamlı değildir. Ancak şiddetli ve yaygın lezyonu bulunan olgularda sistemik tedaviye ek olarak ketakonazol şampuan kullanımının iyileşmeye katkı sağlayacağını düşünmekteyiz.

Comparing efficacy of itraconazole versus itraconazole plus 2% ketoconazole shampoo in the treatment of pityriasis versicolor: Retrospective study

Background and Design: Tinea versicolor is a frequent superficial fungal infection caused by a lipophilic yeast; Malessezia furfur. Topical ketoconazole shampoo and systemic itraconazole can be used for the treatment of tinea versicolor. In this study, the efficiency of itraconazole versus itraconazole plus 2% ketoconazole shampoo in the treatment of tinea versicolor is evaluated retrospectively. Materials and Methods: The patients, who were admitted to dermatology department between 1998-2002 and diagnosed as tinea versicolor, were retrospectively evaluated. The patients who had disseminated lesions and were administered only itraconazole and itraconazole plus 2% ketoconazole shampoo were enrolled in the study. Fifty one patients; 29 (56.9%) male, 22 (43.1%) female were examined. Thirty two (62.7%) patients were administered itraconazole and 19 (37.3%) patients itraconazole plus 2% ketokonazole shampoo. Results: In the itraconazole group 21 (65.6%) patients recovered, and 11 (34.4%) patients did not. In the itraconazole plus 2% ketoconazole shampoo group the result were 17 (89.5%) and 2 (10.5%) respectively. These results showed that there was no significant difference in efficacy between the two treatment methods. Conclusion: In this report, it is shown that the recovery ratio in tinea versicolor lesions was higher in itraconazole plus 2% ketoconazole shampoo group than single itraconazole group, but this result is not statistically significant, and it is concluded that 2% ketoconazole shampoo may be combined by itraconazole in for the treatment of generalized tinea versicolor lesions.

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