***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Flutrimazole is an imidazole derivative that has been proven to be efficient in superficial skin fungal infections . The aim of this r and omised double-blind study was to compare for the first time , the efficiency and safety of flutrimazole 1 % shampoo versus ketoconazole 2 % shampoo in the treatment of tinea versicolor . Study population consisted of 60 patients with pityriasis versicolor diagnosed clinical ly and through direct microscopy and culture . Patients were r and omly assigned to two groups : one instructed to apply flutrimazole shampoo 1 % and one instructed to apply ketoconazole shampoo 2 % both on head and body for 14 days . Patients were re-evaluated 14 days after the end of treatment clinical ly and through direct microscopy and culture . Twenty-one of 26 patients ( 80.8 % ) in the ketoconazole and 22 of 29 patients ( 75.9 % ) in the flutrimazole group had both visual healing and negative mycological evaluation . Comparison of the response between the two groups with the Yates ' corrected chi-square was found statistically not significant ( chi(2 ) = 0.19 , d.f . = 1 , P = 0.91 ) . None of the patients in the two groups reported any adverse effects . Fourteen ( 53 % ) patients in the ketoconazole group and 23 ( 79 % ) in the flutrimazole group assessed the shampoos as cosmetically acceptable regarding texture , smell and foam properties .  Flutrimazole shampoo 1 % appears to present efficacy comparable with ketoconazole 2 % in the treatment of tinea versicolor Malassezia furfur ( Pityrosporum orbiculare ) was confirmed by microscopic potassium hydroxide ( KOH ) examination in 101 patients with recurring lesions of tinea versicolor . In a double-blind comparative study , patients were r and omly assigned to once-daily ketoconazole 2 % or placebo cream . At the end of treatment , 98 % ( p less than 0.0001 ) of the patients using ketoconazole and 28 % of those using placebo  responded clinical ly ( healed or had mild residual disease ) . There was an overall 84 % mycologic cure rate ( negative KOH at treatment end ) for patients using ketoconazole 2 % cream and 10 % for those using placebo cream ( p less than 0.0001 ) . Ketoconazole-treated patients who were cured at the end of treatment remained cured 8 weeks later . By contrast 75 % of those responding to placebo had relapsed by the 8-week follow-up visit . Follow-up after 2 years revealed that 79 % ( 38/48 ) of the patients treated with ketoconazole remained clear 12 or more months Abstract Background : Ketoconazole cream and adapalene gel are effective drugs against pityriasis versicolor . However , there are no reports on combination treatment with both compounds in pityriasis versicolor . Objective : To evaluate the efficacy and safety of combination therapy with adapalene 0.1 % gel and ketoconazole 2 % cream against pityriasis versicolor . Methods : Participants with pityriasis versicolor were r and omly assigned to two groups : the combination group was treated with adapalene 0.1 % gel and ketoconazole 2 % cream once daily , and the monotherapy group received ketoconazole 2 % cream twice daily . The treatment lasted 2 weeks in both groups . Outcomes were assessed at baseline and 1 , 2 and 4 weeks after the initiation of treatment . Results : We noted clinical ly significant differences in total improvement rates between groups Weeks 1 and 2 . A statistically significant difference was obtained Week 4 . The treatment was well tolerated by all participants . Conclusions : The combination of adapalene 0.1 % gel and ketoconazole 2 % cream is effective and safe in the treatment of pityriasis versicolor . This therapeutic regimen was rapid , providing a valuable option for patients with pityriasis versicolor BACKGROUND Tinea versicolor is a common superficial fungal infection caused by a lipophilic yeast . This chronically recurring opportunistic infection is especially prevalent in tropical and semitropical regions . The topical short-term application of ketoconazole 2 % shampoo may provide effective and safe therapy for tinea versicolor . OBJECTIVE The purpose of this study was to evaluate the efficacy and safety of a single application ( 1 day ) versus three daily applications ( 3 days ) of ketoconazole 2 % shampoo versus placebo shampoo in the treatment of mycologically confirmed tinea versicolor . METHODS Three hundred twelve patients were included in the primary analyses for this 31-day study . Global evaluation scores were measured on days 10 and 31 with a 5-point scale ( 1 = healed to 5 = worsening ) , and a cellophane tape test was done at baseline and days 3 , 10 , and 31 . Efficacy was assessed by clinical response , defined as both a global evaluation score of 1 ( healed ) and a negative cellophane tape test on day 31 . Signs and symptoms of tinea versicolor ( scaling , itching , erythema , hypopigmentation , hyperpigmentation ) also were evaluated at baseline , day 10 , and day 31 with a 4-point scale ( 0 = absent to 3 = severe ) . RESULTS Both regimens of ketoconazole shampoo were significantly ( P < .001 ) more effective than placebo for rate of clinical response , global evaluation scores , and mycologic outcomes ( cellophane tape test ) . The clinical response rates at day 31 were 73 % , 69 % , and 5 % for the 3-day ketoconazole , 1-day ketoconazole , and placebo groups , respectively . The difference in the efficacy of the two ketoconazole treatment regimens was not statistically significant . There were no significant differences between any of the treatment groups in the number of patients who experienced adverse events . No serious adverse events occurred and no patient withdrew from the trial prematurely because of an adverse event . CONCLUSION Ketoconazole 2 % shampoo , used as a single application or daily for 3 days , is safe and highly effective in the treatment of tinea versicolor The antifungal efficacy and tolerability of 1 % terbinafine cream vs. 1 % bifonazole cream were assessed in a single blind r and omized trial in patients with pityriasis versicolor .  Terbinafine , a drug of the allylamines group , a new class of anti-mycotic agents , blocks sterol bio synthesis in the pathogen through inhibition of squalene epoxidase and consequent squalene accumulation , a primarily fungicidal process . Forty pityriasis versicolor patients , ( 18 M , 22 F ; mean age 32.4 years ; min . 16 , max . 65 ) , used 1 % terbinafine cream or 1 % bifonazole cream for a maximum of 4 weeks . All patients were followed-up weekly both clinical ly and mycologically . Clinical cures , defined as negativization of each clinical parameter , were recorded for 20 terbinafine patients ( 100 % ) and 19 bifonazole patients ( 95 % ) , with routine microscopy and Wood 's light tests both negative . By the 2nd week of treatment , 2 terbinafine patients were mycologically cured ( 10 % ) . By the 3rd week , 14 terbinafine patients ( 70 % ) and 5 bifonazole patients ( 25 % ) were mycologically cured . The present controlled clinical trial consequently demonstrates that terbinafine is rapidly effective and well tolerated for treatment of pityriasis versicolor An open , comparative trial of two brief regimens of itraconazole for pityriasis versicolor was carried out . Twenty-four patients received 100 mg twice a day for five days , and 23 received 100 mg once a day for five days . Patients were enrolled in the study on the basis of the presence of clinical symptoms and positive findings on direct microscopic examination .  Tolerance to the drug and mycologic and clinical outcome were assessed on days 6 , 14 , and 28 after the initiation of treatment . For 23 patients in each group , skin sample s were negative for fungi by day 18 . Clinical improvement was slow ; first scaling disappeared and then erythema and inflammation . Dyschromia persisted during the observation period . Six patients had adverse reactions to treatment ; none discontinued treatment BACKGROUND The use of short-term oral azoles is an alternative to topical therapy in patients with tinea versicolor . OBJECTIVE We compared the efficacy and safety of oral itraconazole with that of placebo in 36 patients with mycologically proven tinea versicolor . METHODS Patients were r and omly assigned to 7 days of treatment with either itraconazole , 200 mg once daily , or placebo . A potassium hydroxide examination and assessment of scaling , erythema , pruritus , and global condition were performed at baseline and at 4 weeks after treatment . RESULTS The itraconazole-treated group demonstrated significant improvement over both baseline ( p < 0.01 ) and placebo ( p < 0.02 ) in scaling , erythema , and pruritus . Sixty-seven percent of itraconazole-treated patients were free of symptoms at week 5 , as compared with 12 % of placebo-treated patients . Ninety-four percent of itraconazole-treated patients were considered to be healed or markedly improved at the study 's end point compared with 6 % of placebo-treated patients ( p < 0.01 ) . A total of 89 % in the itraconazole-treated group had a negative potassium hydroxide examination at the follow-up visit compared with 6 % in the placebo-treated group ( p < 0.01 ) . There was a single report of a possibly treatment-related adverse event in each treatment group . CONCLUSION Short-term treatment with itraconazole is effective and well tolerated in the management of tinea versicolor Two r and omized , double-blind , parallel-group studies , each conducted at five medical centers , assessed the efficacy and safety of a new antifungal agent , ciclopirox olamine cream 1 % , in patients with tinea versicolor . In one study , the antifungal agent was compared with its cream vehicle ; in the other , it was compared with another antifungal compound , 1 % clotrimazole cream . In both studies , treatments were applied twice daily for 14 days . Results with ciclopirox olamine cream were significantly better ( P less than 0.05 ) than those with the vehicle alone after one and two weeks of therapy and at one and two weeks posttherapy . After two weeks of treatment , 49 % of the 73 patients treated with the antifungal cream were clinical ly and mycologically cured , whereas only 24 % of the 72 patients using the vehicle were similarly cured ( P less than 0.001 ) . The clinical cure rate with ciclopirox olamine cream also was significantly better ( P less than 0.05 ) than that with clotrimazole cream . After two weeks of treatment , 77 % of the patients treated with ciclopirox olamine , compared with 45 % of those treated with clotrimazole , had both clinical and mycological cures ( P less than or equal to 0.001 ) . Fourteen days posttreatment , the proportion of patients with a combined response was still greater in the ciclopirox olamine group ( 86 % ) than in the clotrimazole group ( 73 % ) . No side effects were observed in any treatment group Ketomousse ( K ) , a new thermophobic formulation ( ketoconazole 1 % ) , has proven its efficacy in the treatment of d and ruff , caused by the same agent as pityriasis versicolor ( PV ) . The objective of this study was to compare the efficacy and tolerability of K thermophobic foam vs. ketoconazole cream 2 % ( N ) in the treatment of PV . Forty-six patients ( 22 in K and 24 in N group ) with PV involving no more than 15 % of the total trunk surface were r and omly assigned for treatment either with K or N once daily for 14 days . Three weeks after the completion of treatment , improvement rate and side-effects were evaluated by clinical and mycological examination ( Wood 's light ) . Follow-up was available for 81 % of subjects . Complete resolution was observed in five patients ( 29 % ) in K group and in nine ( 47 % ) in N group ( P = 0.291 ) . One patient in the N group reported urticaria while no adverse events were reported for K. Both products were cosmetically acceptable with respect to feasibility of application and formulation with a preference for K. Ketomousse ( 1 % ketoconazole ) provides an equal efficacy and tolerability compared to ketoconazole cream 2 % . Therefore , Ketomousse could be considered an excellent therapeutic option in the treatment of PV BACKGROUND : Tinea ( pityriasis ) versicolor is a superficial infection of the stratum corneum by the lipophilic fungus known as Malassezia furfur . OBJECTIVE : To evaluate the efficacy and safety of a 400 mg single dose or 7-day 200 mg daily dose of itraconazole capsules in the treatment of mycologically confirmed pityriasis versicolor . METHODS : A total of 50 patients were entered 
    Output:
    
Conclusions : Topical antifungal medications are the first-line treatment for PV , including zinc pyrithione , ketoconazole , and terbinafine .
In cases of severe or recalcitrant PV , the oral antifungal medications itraconazole and fluconazole may be more appropriate , with pramiconazole a possible future option .
Maintenance , or prophylactic , therapy may be useful in preventing recurrent infection ; however , at this time , there is limited research evaluating the efficacy of prophylactic antifungal treatment