Premium
Efficacy of topical vs combined oral and topical antifungals in white piedra of the scalp
Author(s) -
El Attar Yasmina,
Atef Shams Eldeen Maii,
Wahid Reham M.,
Alakad Rania
Publication year - 2021
Publication title -
journal of cosmetic dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.626
H-Index - 44
eISSN - 1473-2165
pISSN - 1473-2130
DOI - 10.1111/jocd.13769
Subject(s) - medicine , clotrimazole , scalp , itraconazole , dermatology , terbinafine , dosing , group b , antifungal
Background Topical antifungals are the most commonly used therapy in white piedra of the scalp. However, persistence and relapse of infection still pose a significant challenge. Systemic antifungals have been recommended to enhance the therapeutic response. Aims To compare the efficacy of topical antifungal alone versus combined topical and oral antifungals in the treatment of white piedra of the scalp. Methods Sixty patients with white piedra of the scalp were divided into 3 groups, each containing 20 patients. Group A received topical clotrimazole, group B received combined topical clotrimazole and oral itraconazole, and group C received combined topical clotrimazole and oral terbinafine. The treatment was continued until clearance of infection was confirmed by dermoscopic and mycological examination. Positive responders were followed up for 3 months after treatment. Results All the patients achieved complete clearance of infection. The median treatment time in group B was significantly shorter than group A ( P < .001) and group C ( P < .001), respectively. In addition, the median treatment time in group C was significantly shorter than group A ( P = .002). No recurrence of infection was noted during follow‐up period. Conclusion The three modalities were effective in the treatment of white piedra of the scalp. The most rapid response was observed with the combined use of topical and oral azoles.