Determination of cost effective topical therapy for pityriasis versicolor
Keywords:
Ketoconazole gel, selenium sulphide shampoo, sulphur-salicylic acid soap, pityriasis versicolor.Abstract
Objective To compare the cost, efficacy and compliance between shampoo (2.5 % selenium sulphide), soap (3% salicylic acid-10% sulphur), and gel (2% ketoconazole) in the treatment of pityriasis versicolor. Patients and methods This comparative, randomized, single-blind clinical trial study was carried out at Combined Military Hospital Multan from May 2005 to September 2005. After randomization and assessment of inclusion criteria, patients with diagnosis of pityriasis versicolor were divided into three groups. Group I applied shampoo for 10 minutes daily for 1 week. Group II applied soap for 5 minutes daily for a period of 4 weeks. Group III applied gel for 5 minutes daily for 5 days. Cure was defined as negative skin scrapings for fungal hyphae at the end of treatment period. Cost of treatment was defined as cost of treatment for the group at baseline divided by the number of cured patients in each group at the end of treatment period. Efficacy was defined as the percentage of cure rate achieved at the end of treatment period. Compliance was defined as the number of patients completing treatment in each group. Patients were evaluated at presentation, at the end of treatment, and followed up at 4 weeks post treatment. Results 90 patients were enrolled, 63 patients completed the treatment period, and 44 patients completed the follow up period. In group I, compliance was 66.6% and efficacy was 60%. The total cost incurred, per cured patient, Rs 275. In group II, compliance was 60% and efficacy 50%. The total cost per cured patient was Rs. 350. In group III, compliance was 83% and efficacy 92%. The cost incurred was Rs. 262 per cured patient. P value was >.05 for all three parameters. Conclusion 2% topical ketoconazole gel resulted in better compliance, efficacy and lower cost than keratolytic soaps and selenium sulphide shampoo in treating pityriasis versicolor.ÂReferences
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