Ketoconazole 2% cream versus a combination of ketoconazole 2% cream and adapalene 0.1% gel in the treatment of pityriasis versicolor

Background and aim Pityriasis versicolor is a common chronic superficial fungal infection that manifests during or after puberty in hot humid temperatures. Topical treatments, which are the first line of treatment, are divided into nonspecific and specific antifungal agents; however, the therapeutic approaches for pityriasis versicolor depend mainly on synthetic antifungal drugs, in particular ketoconazole. However, due to the frequent recurrence of this disease, and the widespread application of azole drugs, resistant strains have emerged leading to increasingly failed treatment rates. Retinoic acid creams are also effective against pityriasis versicolor. Especially adapalene gel that has less irritation compared with other topical retinoid products and also has rapid onset of action. Therefore, we aimed to evaluate the efficacy and safety of a combination treatment of ketoconazole cream 2% and adapalene gel 0.01% in the treatment of pityriasis versicolor. Patients and methods In all, 100 patients were divided equally into two groups: group 1 patients were treated with topical application ketoconazole 2% cream and adapalene 0.1% gel once daily for a total duration of 2 weeks. Group 2 patients were treated with a topical application ketoconazole 2% cream for a total duration of 2 weeks. Results There was significant improvement rates in the combined group than ketoconazole-only group with P value=0.023. Adepalene+ketoconacole group had more irritation as a side effect than the ketoconazole group with significant P value=0.001. Conclusion The combination of adapalene 0.1% gel and ketoconazole 2% cream is safe, rapid, and effective in the treatment of pityriasis versicolor.