Ketoconazole tablets in a topical vehicle as treatment for pityriasis versicolor in a 32-year-old male: Case report

Abstract

A case is presented of a 32-year-old male patient who attended the clinic due to erythematous-desquamative macular lesions generalized on the trunk and upper extremities, with 8 months of evolution. Pityriasis versicolor was clinically suspected, a diagnosis confirmed by direct microscopy of desquamative cells, revealing yeast-like forms and short hyphae compatible with Malassezia spp. Topical treatment with 2% ketoconazole cream was considered, but the patient had economic limitations preventing access to the commercial presentation. As an alternative, a magistral formulation was institutionally prepared by crushing 200 mg ketoconazole tablets and incorporating them into a moisturizing base cream to achieve a 2% concentration. The patient applied the cream twice daily for seven days. One week after starting treatment, complete clinical resolution of the lesions was evidenced, and direct microscopy was negative for fungal elements. This case demonstrates that magistral formulation of topical ketoconazole from tablets constitutes an effective, safe, and low-cost alternative for pityriasis versicolor in resource-limited settings.