![]() Other adverse side effects include nausea, gynaecomastia, infertility, decreased libido and oligospermia. Though usually well tolerated, the most worrisome adverse reaction to ketoconazole is hepatotoxicity (incidence of between 1 in 10000–15000). By a slower route, it reaches the basal cells of the epidermis and sebum after 3–4 weeks. Since ketoconazole is excreted in the eccrine sweat, methods such as exercise can be used to promote delivery of the drug to the skin. Ketoconazole is absorbed in the small intestine and is rapidly carried (in 1 hour) via sweat and passive diffusion through the blood to the skin, where it stays in the stratum corneum for 10–12 days. It is a substituted imidazole derivative and inhibits the biosynthesis of ergosterol a major membrane lipid of the causative yeast. 3-6 Ketoconazole was the first oral antifungal drug to be shown to be effective in the treatmentof TV. For this reason TV is perhaps more easily treated with systemic agents such as ketoconazole, itraconazole and fluconazole. The main problem with the use of topical antifungals is the difficulty of applying creams to such a large body surface area. But, according to investigators, all topical therapies are associated with a relatively high recurrence rate (60–80%). Dermatologists uses many single or combined, superficial or systemic drugs in the treatments of TV. There is often a positive family history of the disease. TV is common in the post-pubertal age where sebaceous glands are active and in individuals who sweat more. The disease is most prevalent in early adulthood and small children are rarely affected. The aetiological agent is Malassezia furfur (also called Pityrosporum orbiculare or P. TV is found worldwide, but is most prevalent in the tropics where there is high humidity, high temperatures and frequent exposure to sunlight. There by, predisposing the person to the infection. Rao et al, has also found that, 35% of the patients had the disease first in summer and this could probably be due to increased sweating. Klenket al has observed that Tinea versicolor is more frequently seen in humid, warm climates or in the tropics than in dry cold zones. Colour of the affected skin can vary from brown to red and hypo-pigmented patches may also be present. These patches may be lighter or darker in color than the surrounding skin and most commonly affect the trunk and shoulders. The fungus interferes with the normal pigmentation of the skin, resulting in small, discolored patches. It is a very common fungal infection of the skin. Tinea versicolor is caused by a type of yeast that naturally lives on human skin. Both the drugs work by inhibiting the cytochrome P450 dependent enzyme and are used widely in the treatment arena of Dermatology. Ketoconazole has two Nitrogen atoms in it’s azole ring and fluconazole has three N-atoms. Introduction Both fluconazole and ketoconazole are Azole antifungal agents. Both the antifungal agents of Azole group were well tolerated.ġ. Conclusion: Although in our study we found some superiority of fluconazole regarding efficacy over ketoconazole in treating tinea versicolor but the ratio was not remarkable. On the other hand this rate was 86.67% which was some less than that of Group II and these patients were treated by Ketoconazole. On the other hand, after completing 2 (Two weeks) treatment we got 93.33% mycological cure rate in Group I patients who were treated by fluconazole. On the other hand this rate was 56.67% which was some less than that of Group II and these patients were treated by Ketoconazole. Result: After completing 1 (One week) treatment we got 60% mycological cure rate in Group I patients who were treated by fluconazole. Diagnosis of TV was made clinically and by direct KOH preparation. Patients of Group I (n=30) received 300 mg fluconazole as a single dose and repeated weekly for 2 weeks and patients of Group II (n=30) received 400 mg ketoconazole as a single dose and repeated weekly for 2 weeks. The patients were randomly divided into equal two groups. In total 60 patients with tinea versicolor, age around 15–55 years, were finalized as the study population who has continued up to the end of the full tenure of this intervention. Methods: This comparative prospective study was conducted in the Department of Dermatology of Cumilla Medical College Hospital, Cumilla, Bangladesh during the period from January 2018 to December 2018. ![]() Aim of the study: The aim of this study was to compare the efficacies of fluconazole and ketoconazole in treating tinea versicolor. Tinea versicolor (TV) or pityriasis versicolor is caused by a type of yeast that naturally lives on human skin. Ketoconazole has two Nitrogen atoms in its azole ring and fluconazole has three N-atoms. Introduction: Both fluconazole as well as ketoconazole are Azole antifungal agents.
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