For severe cases of tinea versicolor that don't respond to topical therapy, which systemic antifungal might be used?

In cases of severe tinea versicolor that do not respond to topical treatments, systemic antifungals are necessary to effectively manage the infection. Itraconazole and fluconazole are both effective options for treating tinea versicolor because they work by inhibiting the growth of the Malassezia yeast that causes the condition.

Itraconazole is a triazole antifungal that has strong efficacy against the fungi involved in tinea versicolor. It is often preferred for its effectiveness in treating this condition, particularly in cases that are widespread or resistant to topical treatments.

Fluconazole, also a triazole antifungal, is effective and can be used for systemic treatment as well. Its safety profile and effectiveness make it a viable alternative for cases requiring systemic therapy.

In summary, both itraconazole and fluconazole are suitable systemic antifungals for treating severe, resistant cases of tinea versicolor, which is why the correct answer indicates that either could be utilized in these situations.