Topical 10% Lactic Acid Solution in the Treatment of Pityriasis Versicolor in Comparison with Topical 1% Clotrimazole Solution (Single-blind, comparative and therapeutic study)

Objective: To evaluate the efficacy and safety of topical 10% lactic acid solution in the treatment of Pityriasis versicolor in comparison with topical 1% clotrimazole solution. Patients and Methods: This single-blind, comparative and therapeutic study that was carried out in Baghdad Teaching Hospital-Deparment of Dermatology Venereology during November 2006 – November 2007. Fifty Patients with Pityriasis versicolor were recruited in this work(29 males and 21 females),their ages ranged from 10-58 years with a mean±SD of 28.6±9.07 years. After full detailed history was taken from each patient regarding all relavents points to the disease.Patients were divided randomly into two groups: group (A) on topical 10% lactic acid solution and group (B) on topical 1% clotrimazole solution . The patients had scaly active lesions and positive skin scraping test and had no history of treatment with topical or systemic antifungal drugs for at least two months befor starting therapy. Patients with systemic diseases and those on immunosupressive drugs were excluded from the study. The patients instructed to apply the drugs twice daily for one month. Assesment of each patient was done by clinical examination, Wood s light examination and skin scraping test every two weeks for one month and second month follow up without therapy. Results : The clinical response in patients affected by Pityriasis versicolor was as follow: After two weeks of treatment: There is compelet improvement of lesions in 18 (72%) patients in group (A) versus 4(16%) patient in group (B),and this is statisticaly significant,P value=0.000212. After four weeks of treatment:There is complete improvement in all 25(100%) patients in group (A) versus 24(96%) patients in group (B). Skin scraping test: 3 (12 %) patients were positive at two weeks and all of them were negative at four weeks in group A ,while in group B,19 (76%) patients were positive at two weeks and all of them were negative at four weeks. Chi square can not be determined but it is superior to Gold standard therapy, but new therapy still superior to old therapy. Adverse effects of both drugs were mild itching, burning sensation in 2 (8%) patients on topical 1%clotrimazole solution and in 3 (12%) patients on topical 10% lactic acid solution. These side effects did not require discontinuation of the treatment. Conclusion : Topical 10% lactic acid solution had proved to be an effective and rapid new remedy for the treatment of Pityriasis versicolor infections.