Oral itraconazole as a pulse therapy

The aim of this randomised, blinded, controlled study was to evaluate the efficacy of a pulse therapy with itraconazole in dogs suffering from Malassezia dermatitis. Twenty dogs presented with a generalized pruritic skin disease were included. In each case, large numbers of Malassezia spp. were demonstrated on microscopical examination of tape-strips. Dogs were randomly allocated to two groups: group A (ketoconazole 10 mg/kg/day) and group B (itraconazole 5 mg/kg twice a week). Dogs were checked after three weeks. Parameters studied were:pruritus, clinical signs (CADESI) and number of Malassezia on cytological preparations. No significant difference was observed between the two groups for any of the parameters studied. At D21, pruritus decreased by 50% (group A) to 55% (group B). CADESI markedly improved (60% in group A, 61% in group B). The mean number of Malassezia was 4.2 and 3.8 for group A and group B respectively at D0 and 0.2 and 0.1 at D21. A pulse therapy with itraconazole seems to be as effective as the daily administration of ketoconazole. This may be due to the persistence of itraconazole in the stratum corneum for long periods after discontinuation of therapy