Comparison of the efficacy of 2% ketoconazole shampoo vs. 2% climbazole shampoo in the treatment of pityriasis versicolor

Background: Pityriasis versicolor is a recurrent non-inflammatory superficial fungal infection. Application of antifungal shampoo is a simple treatment modality for pityriasis versicolor that can be used on an extensive surface area. Currently, there is no study to evaluate the efficacy of climbazole shampoo. In this study, the efficacy of 2% ketoconazole shampoo was compared to 2% climbazole shampoo in the dermatologic clinic of Afzalipour Hospital, Kerman, Iran. Methods: This triple-blind randomized clinical trial was performed on 60 patients diagnosed with pityriasis versicolor. Participants were categorized into groups A (ketoconazole shampoo) and B (climbazole shampoo) based on simple randomization. KOH smear was achieved from all participants at the baseline, four weeks after commencing treatment, and at three months follow– up. Participants were instructed to apply shampoo three times a week for three weeks on all body surfaces and scalp for 10 minutes before rinsing. Evaluation of treatment was based on clinical improvement and results of KOH smears. Complete cure was defined as negative KOH smear and complete clinical improvement. Results: Seventy percent of the patients in the ketoconazole group and 43.3% of the patients in the climbazole group had negative smears four weeks after commencing treatment (P = 0.037). Complete clinical improvement at the three-month follow-up was 26.7% and 13.3% in the ketoconazole and climbazole groups, respectively (P = 0.402). Conclusion: In the present study, 2% ketoconazole shampoo had significantly greater efficacy in terms of mycological cure than climbazole shampoo among pityriasis versicolor patients.