Comparative Study of Efficacy of Combined Treatment with Ketoconazole 2% Cream and Adapalene 0.1% Gel Versus Ketoconazole 2% Cream Monotherapy in Pityriasis Versicolor

Parwarish; Rabia Ghafoor

doi:10.70749/ijbr.v3i5.1702

Authors

Parwarish Department of Dermatology, Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan
Rabia Ghafoor Department of Dermatology, Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan

DOI:

https://doi.org/10.70749/ijbr.v3i5.1702

Keywords:

Adapalene, Antifungal Treatment, Ketoconazole, Pityriasis Versicolor

Abstract

Background and Aim: Pityriasis versicolor is a frequent cutaneous superficial mycotic infection of Malassezia species manifesting as hypopigmented or hyperpigmented scaly macules. Although topical antifungals such as ketoconazole are often employed, relapse and partial resolution of skin color changes are common. Recent observations suggest that the concurrent use of antifungals with agents such as adapalene (a topical retinoid) might have the potential to improve the treatment effectiveness by stimulating epidermal turnover and antifungal penetration. The present study aimed to compare the ketoconazole 2% cream and adapalene 0.1% gel combined treatment efficacy with ketoconazole 2% cream monotherapy in patients with pityriasis versicolor. Patients and Methods: This comparative study investigated fifty patients with pityriasis versicolor in the Department of Dermatology JPMC Karachi from December 05, 2024 to March 04, 2025. Patients were randomly allocated to two groups of 25 each. Patients in whereas Group-A were administered with ketoconazole 2% cream once daily and Group-B a combined therapy based on ketoconazole 2% cream (once daily) and adapalene 0.1% gel (applied nightly). Clinical score and mycological (KOH examination) findings were recorded at baseline and at the end of treatment. Efficacy was assessed based on lesion clearance, symptom resolution, and mycological cure rates. SPSS version 20 used for data analysis. Results: At the end of 4 weeks, Group A (combined therapy) showed significantly higher clinical improvements and high mycological treatment rates than Group B (monotherapy). Group A (P <0.05) complete clearance seen in 84% of patients in Group B vs 60%. The adverse effects were limited to minimum and mild local irritation in the adapalene group, which was spontaneously resolved. Conclusion: The combination of ketoconazole 2% cream and adapalene 0.1% gel proved to be more effective than ketoconazole monotherapy in pityriasis versicolor treatment, with a better clinical and micological reaction. This combination can represent a more efficient timely approach, especially in cases with resistant or recurrent lesions.

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