title: Comparative efficacy of topical application of tacrolimus and clotrimazole in the treatment of pityriasis versicolor: A single blind, randomised clinical trial.
abstract: BACKGROUND
  Pityriasis versicolor (PV) is a common superficial fungal disease. Possibility of emergence of resistant strains to azoles, and difficulty in differentiation of hypopigmented PV and early vitiligo, encouraged us to evaluate the efficacy of topical tacrolimus (a calcineurin inhibitor agent with proven in vitro anti-Malassezia effect) for PV treatment generally and its effect on PV-induced hypopigmentation specifically.
  
  
  OBJECTIVE
  To evaluate the efficacy of topical tacrolimus on pityriasis versicolor.
  
  
  METHODS
  Fifty PV patients were randomly allocated into two equal groups applying either topical clotrimazol or tacrolimus twice daily for 3 weeks. They were evaluated at the beginning of study, in the third and fifth weeks clinically and mycologically (direct smear).
  
  
  RESULTS
  Although both treatments resulted in global, clinical, and mycological cure of PV, there was no significant difference regarding the mentioned aspects of cure between tacrolimus and clotrimazole treated patients. (P-value: .63, .45, and .26, respectively) Tacrolimus had no significant effect on hypopigmentation in the fifth week follow-up. (P-value: .62).
  
  
  CONCLUSIONS
  In spite of the lack of efficacy of tacrolimus on PV-induced hypopigmentation, the therapeutic effect on PV introduces tacrolimus as a therapeutic option for PV, especially when early vitiligo is among the differential diagnoses without concerning the aggravating effect of topical corticosteroids on PV.
authors.affiliation: Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mozhdeh
authors.identifier: http://orcid.org/0000-0002-8773-0019
authors.initials: M
authors.lastname: Sepaskhah
authors.affiliation: Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Maryam Sadat
authors.initials: MS
authors.lastname: Sadat
authors.affiliation: Basic Sciences in Infectious Diseases Research Center, Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Keyvan
authors.identifier: http://orcid.org/0000-0001-7809-4690
authors.initials: K
authors.lastname: Pakshir
authors.affiliation: Department of Biostatistics, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Bagheri
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D000935:Antifungal Agents / Q000008:administration & dosage*; D003022:Clotrimazole / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D017496:Hypopigmentation / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D010915:Pityriasis / Q000188:drug therapy* / Q000382:microbiology; D016037:Single-Blind Method; D016559:Tacrolimus / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D000935:Antifungal Agents; D003022:Clotrimazole; D016559:Tacrolimus
keywords: antifungal agents; clotrimazole; pityriasis versicolor; skin infection; tacrolimus; treatment; yeast