ABSTRACT
@#<p style="text-align: justify;"><strong>Background:</strong> Oral azole drugs are a second-line option for the treatment of pityriasis versicolor but evidence on their efficacy and safety is unclear. Objectives. To determine the efficacy and safety of oral azoles in the treatment of patients with pityriasis Versicolor.</p><p style="text-align: justify;"><strong>Methods</strong>: We searched MEDLINE, CENTRAL, EMBASE, LILACS, and HERDIN, from inception to the period between January to February 2014. We did not restrict the search by language or publication status. We included randomized controlled trials (RCTs) that compared the efficacy of oral azoles with placebo or no treatment, with topical agents, other oral azoles or dosing regimens in the treatment of pityriasis Versicolor, and that measured any of the pre-specified outcomes (mycologic cure, clinical cure, recurrence, duration to cure, time-to-cure, and quality of life). For adverse effects, we also included non-randomized studies (NRS). We used Cochrane methods to select studies, extract data, assess the risk of bias, pool studies, and calculate for treatment effects.</p><p style="text-align: justify;"><strong>Results:</strong> We included 38 RCTs (n=2894) and 56 NRS (n=3452). Overall, there were few pooled studies and evidence was low to moderate quality. Oral azoles were more effective than placebo (mycologic cure, RR 11.34, 95% CI 4.90, 26.28; 3 RCTs, n=131; I2=0%; low quality of evidence) and as effective as topical agents (mycologic cure, RR 1.02, 95% CI 0.86, 1.21; 4 RCTs, n=232; I2=60%; moderate quality of evidence).There were few adverse effects and were mostly minor and transient.</p><p style="text-align: justify;"><strong>Conclusions:</strong> Oral azoles may be more effective than placebo, and are probably as effective as topical agents in the treatment of PV. Triazoles are probably as effective as ketoconazole. Adverse effects were few, mostly minor, and transient.</p>
Subject(s)
Ketoconazole , Itraconazole , Fluconazole , Tinea Versicolor , Pityriasis , Systematic Review , Meta-AnalysisABSTRACT
No abstract available.
Subject(s)
Humans , Keratoderma, Palmoplantar , Pityriasis Rubra Pilaris , Pityriasis , SiblingsABSTRACT
No abstract available.
Subject(s)
Adult , Humans , Acrodermatitis , Pityriasis Rubra Pilaris , Pityriasis , ZincABSTRACT
Tinea versicolor (TV) is a common fungal skin disease caused by the Malassezia species. This disease usually presents as hypopigmented- or hyperpigmented coalescing scaly macules, papules, patches or plaques on the trunk and upper arms. Herein, we report a rare clinical manifestation of TV in a 29-year-old man presenting with marked follicular, erythematous, and hyperkeratotic papules on the trunk with erythematous scaly macules and patches on the upper extremities with intermittently spared skin. We initially suspected pityriasis rubra pilaris, however, skin biopsy results and mycological examination revealed TV. Polymerase chain reaction-based sequence analysis revealed Malassezia globosa. The patient was successfully treated with oral itraconazole and topical terbinafine.
Subject(s)
Adult , Humans , Arm , Biopsy , Dermatomycoses , Itraconazole , Malassezia , Pityriasis Rubra Pilaris , Pityriasis , Sequence Analysis , Skin , Tinea Versicolor , Tinea , Upper ExtremityABSTRACT
BACKGROUND: Pityriasis lichenoides (PL)-like skin lesions rarely appear as a specific manifestation of mycosis fungoides (MF). OBJECTIVE: We investigated the clinicopathological features, immunophenotypes, and treatments of PL-like MF. METHODS: This study included 15 patients with PL-like lesions selected from a population of 316 patients diagnosed with MF at one institution. RESULTS: The patients were between 4 and 59 years of age. Four patients were older than 20 years of age. All of the patients had early-stage MF. In all patients, the atypical lymphocytic infiltrate had a perivascular distribution with epidermotropism. The CD4/CD8 ratio was <1 in 12 patients. Thirteen patients were treated with either narrowband ultraviolet B (NBUVB) or psoralen+ultraviolet A (PUVA), and all of them had complete responses. CONCLUSION: PL-like MF appears to have a favorable prognosis and occurrence of this variant in adults is uncommon. MF should be suspected in the case of a PL-like skin eruption. Therefore, biopsy is required to confirm the diagnosis of PL-like MF, and NBUVB is a clinically effective treatment.
Subject(s)
Adult , Humans , Biopsy , Diagnosis , Mycosis Fungoides , Phototherapy , Pityriasis Lichenoides , Pityriasis , Prognosis , SkinABSTRACT
BACKGROUND: Pityriasis lichenoides, an inflammatory skin condition of unknown etiology affecting both children and adults encompasses a clinical spectrum between pityriasis lichenoides et varioliformis acuta (PLEVA) and pityriasis lichenoides chronica (PLC). Although reported to follow a more self-limiting course in children compared with adults, there are a few studies comparing pityriasis lichenoides in both age groups in Korea. OBJECTIVE: The aim of this study was to evaluate the clinicopathological features, overall efficacy of treatments, and disease outcomes in children and adults diagnosed with pityriasis lichenoides. METHODS: This was a retrospective study of pityriasis lichenoides at our center between January 2003 and December 2013. Clinical manifestations and histopathological features of 54 patients with pityriasis lichenoides were analyzed. We also evaluated the clinical course in children and adults according to Gelmetti's classification. RESULTS: In this study, 36 patients were children (mean age 11.6 years, range 3approximately18 years) and 18 patients were adults (mean age 34.7 years, range 19approximately55 years). Lesions on the face were observed more commonly in children (n=18, 50%) compared with adults (n=1, 5.5%). Of the clinical features, vesiculation, crust and pigmentary changes were significantly more common in children than in adults. After treatment, 12 children (33.3%) and 10 adults (55.6%) went into complete remission. Histopathological features were not significantly different between children and adults. They just showed the difference between PLEVA and PLC. Dyskeratosis, epidermal necrosis, intraepidermal red blood cell (RBC) trapping, and RBC extravasati on in the dermis were more prominent in PLEVA than in PLC. By Gelmetti's classification, disease duration was longer in children with the peripheral type (38.5 months) than in children with the diffuse and central types. In adults, the diffuse type lasted longer (24.5 months) than the central and peripheral types. CONCLUSION: This study suggests that, compared with adults, pityriasis lichenoides in children is more likely to follow an unremitting course, with more facial/acral involvement and pigmentary changes and a poorer response to conventional treatment modalities. Applying the Gelmetti's classification, disease duration was longer in children with the peripheral type than other types. However, in adults, the duration was longer with the diffuse type.
Subject(s)
Adult , Child , Humans , Classification , Dermis , Erythrocytes , Korea , Necrosis , Pityriasis Lichenoides , Pityriasis , Retrospective Studies , SkinABSTRACT
No abstract available.
Subject(s)
Methotrexate , Pityriasis Lichenoides , Pityriasis , PrednisoloneABSTRACT
BACKGROUND: Pityriasis alba affects 1% of the world population and about 9.9% of the children in Brazil. However, its etiology remains uncertain. OBJECTIVE: The objective of the present study was to evaluate the immunoexpression of factor XIIIa in dermal dendrocytes of skin lesions of pityriasis alba. METHOD: Twenty patients with pityriasis alba and 20 patients with atopic dermatitis underwent biopsy. The dermal dendrocytes marked by factor XIIIa were counted by means of immunohistochemical analysis. RESULTS: The mean amount of dermal dendrocytes found in the patients with pityriasis alba was 2, whereas in the patients with atopic dermatitis it was 4, with a statistically significant difference between them. A cutoff point of 3 cells/square inch was established to differentiate pityriasis alba from atopic dermatitis, with 80% sensibility and 90% specificity. CONCLUSION: We believe that pityriasis alba and atopic dermatitis should be considered different clinical forms within the spectrum of atopic disease, in which sun radiation plays an important role by modulating the progression of the disease. .
Subject(s)
Female , Humans , Male , Dermatitis, Atopic/pathology , Factor XIIIa/analysis , Langerhans Cells/pathology , Pityriasis/pathology , Biopsy , Cross-Sectional Studies , Disease Progression , Immunohistochemistry , ROC Curve , Statistics, Nonparametric , Skin/pathologyABSTRACT
Acquired hypopigmentary disorders comprise a significant group of disorders that affect Indians and Asians. The pigment disturbance in darker skin individuals can be very distressing to the patient and the family. These disorders cover a wide array of pathologies including infections, autoimmune processes, lymphoproliferative disorders, and sclerosing diseases. Histological diagnosis is particularly important because treatments for these diseases are varied and specific. This review will focus on histopathological diagnosis based on clinicopathological correlation for commonly encountered disorders such as leprosy, vitiligo, lichen sclerosus, pityriasis alba (PA), and pityriasis versicolor (PV). Atypical or uncommon clinical presentation of classic diseases such as hypopigmented mycosis fungoides (HMF) and hypopigmented sarcoidosis are also included.
Subject(s)
Dermatology/methods , Humans , Hypopigmentation/pathology , Lichen Sclerosus et Atrophicus/pathology , Pathology, Clinical/methods , Pityriasis/pathology , Vitiligo/pathologyABSTRACT
Pityriasis Amiantacea, also known as pseudotinea amiantacea, is a clinical syndrome which affects the scalp, having a reaction pattern reported to occur in several inflammatory dermatoses. The authors seek to establish the correlation between its clinical, dermoscopic and light microscopy features through the analysis of scale- encrusted hair tufts submitted to histological processing.
A pitiríase amiantácea, também chamada de pseudotínea amiantácea, é compreendida como uma síndrome clínica que acomete o couro cabeludo. Representa um padrão de reação a diversas dermatoses inflamatórias. Os autores procuram estabelecer a correlação entre características clínicas, dermatoscópicas e de microscopia ótica, através da análise do tufo de cabelos agregados pelas escamocrostas, submetido a processamento histológico.
Subject(s)
Humans , Pityriasis/pathology , Scalp Dermatoses/pathology , Dermoscopy , Hair/pathologyABSTRACT
Pityriasis rotunda (PR) is a rare disease characterized by persistent, sharply defined, oval, scaly patches of dry skin, localized mainly on the trunk and extremities. Its etiology remains unknown. However, several reports suggest that it is a form of acquired ichthyosis vulgaris or a skin manifestation of systemic disease, such as malnutrition, chronic illness, hepatic disease, and malignancies. Although a variety of treatment modalities, including topical lactic acid, urea, tars, emollients, and corticosteroid, have been applied to it, their efficacies are not satisfactory. Herein, we report a case of PR in a healthy man who was successfully treated with oral and topical retinoids.
Subject(s)
Chronic Disease , Emollients , Extremities , Ichthyosis , Ichthyosis Vulgaris , Lactic Acid , Malnutrition , Pityriasis , Rare Diseases , Retinoids , Skin , Skin Manifestations , Tars , UreaABSTRACT
Atrophying pityriasis versicolor is a rare variant of pityriasis versicolor. Clinically, atrophying pityriasis versicolor is characterized by well defined, slightly scaly, depressed macules and patches with minimal symptoms. The etiology of the atrophy is unknown, though several hypotheses have been suggested, including immune reaction to antigens of Malassezia species. A 23-year-old male was presented with multiple, slightly brown colored macules and patches on the chest and back. In the potassium hydroxide preparation, lots of yeasts and hyphae were found. A histopathologic study showed multiple yeasts and hyphae on the stratum corneum, focal epidermal thinning, and perivascular lymphocytic infiltration on the upper dermis. The patient was treated with 100 mg itraconazole a day with topical antifungal agents. After 3 weeks of treatment, clinical improvement and mycological improvement were achieved. We present an additional case of atrophying piryriasis versicolor developed on the chest and back with the review of the relevant literature.