Pityrosporum orbiculare

Oral treatment offers the advantage of bringing all the lesions at all sites under control, in addition to the absence of unpleasant cosmetic effects. In certain cases, it may be preferable to use oral treatment for C. albicans vaginitis and for extensive and persistent pityriasis versicolor, a skin disorder caused by Pityrosporum orbiculare. In the case of onychomycosis, a combination treatment, topical plus systemic, is required. It is preferable to use oral treatment for deep and systemic mycoses, though intravenous or intrathecal treatment is sometimes required. 

Tolnaftate is topically effective against various dermatophyte infections. It has also activity against Pityrosporum orbiculare but not against Candida species. Local irritation and contact sensitization are rare adverse effects. 

The topical imidazoles, which currently include clotrimazole, econazole, ketoconazole, miconazole, oxiconazole, sulconazole, and sertaconazole, have a wide range of activity against dermatophytes (epidermophyton, microsporum, and trichophyton) and yeasts, including Candida albicans and Pityrosporum orbiculare (see Chapter 48). 

Pityriasis versicolor, a superficial skin infection caused by a yeast, Pityrosporum orbiculare (also known as Malassezzia furfur), can be treated with similar nonprescription preparations to fungal infections. 

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