The correct nomenclature of Zirelí sign in the propaedeutics of pityriasis versicolor (in memoriam)

Abstract Aiming at disclosing the semiotic method used in the diagnosis of pityriasis versicolor, the authors go through the history of the creation of Zirelí sign, describing the method, its usefulness and practicality in dermatological clinical practice, whether public or private, and to give credit to the author of this semiological maneuver, in memoriam.

Especies de Malassezia causantes de pitiriasis versicolor en Paraguay / Malassezia species causative of pityriasis versicolor in Paraguay

Resumen Introducción: La pitiriasis versicolor es una patología frecuente en Paraguay; sin embargo, su epidemiologia es desconocida. Objetivo: Determinar la frecuencia de especies de Malassezia causantes de pitiriasis versicolor y las características epidemiológicas de la población. Materiales y Métodos: Se recolectaron muestras de pacientes con diagnóstico presuntivo de pitiriasis versicolor. El diagnóstico de laboratorio se realizó mediante examen en fresco y cultivo en agar Dixon modificado y agar cromogénico Chromagar Malassezia®, incubados a 32°C; y la identificación por las características macro y micromorfológicas, pruebas bioquímicas y fisiológicas. Resultados: Se incluyeron 102 pacientes (51% femenino), de 1 mes a 63 años de edad, predominando el grupo de 11 a 20 años (35,3%). La localización más frecuente fue el dorso (60,8%). Predominaron las formas hipocrómicas (48%). La especie más frecuente fue M. globosa (52,9%), seguida de M. furfur (24,5%), M. sympodialis (18,6%) y M. slooffiae (6,9%). Conclusiones: La epidemiología observada es similar a otros estudios sudamericanos, no hace distinción de sexo, se presenta predominantemente en la forma clínica hipocrómica y M. globosa aparece como principal responsable. Este es el primer reporte sobre las especies causantes de pitiriasis versicolor en Paraguay y las características de la población con esta patología.

Background: Pityriasis versicolor is a frequent pathology in Paraguay; however, its epidemiology is unknown. Aim: To determine the frequency of Malassezia species causing pityriasis versicolor and the epidemiological characteristics of the population. Methods: Samples from patients with a presumptive diagnosis of pityriasis versicolor were collected. Laboratory diagnosis was carried out by fresh examination and culture in modified Dixon agar and chromogenic Chromagar Malassezia®, incubated at 32° C, and identification by macro and micromorphological features, biochemical and physiological tests. Results: 102 patients were included (51% female) from 1 month to 63 years of age, the predominant age group was 11-20 years (35.3%). The most frequent location was on the back (60.8%). Hipocromic clinical forms (48%) predominated. The most frequent species was M. globosa (52.9%), followed by M. furfur (24.5%), M. sympodialis (18.6%) and M. slooffiae (6.9%). Conclusions: The observed epidemiology is similar to other South American studies, with no sex distinction, predominantly hypochromic clinical form and as primary responsible species appears M. globosa. This is the first report on species causing pityriasis versicolor in Paraguay and the characteristics of the affected population.

Ocorrência de micoses e pitiose em animais domésticos: 230 casos / Occurrence of mycoses and pythiosis in domestic animals: 230 cases

A retrospective study was performed to determine the main mycoses and oomycosis that affected domestic animals diagnosed in the Laboratório de Patologia Veterinária (LPV) of the Universidade Federal de Santa Maria (UFSM). A total of 29,686 exams (9,487 necropsy reports and 20,199 biopsy reports) performed between January 1990 and December 2012 were analyzed. Two hundred and thirty cases (78% of mycoses and 22% of pythiosis) were found. Data about epidemiology, clinical signs, gross and histologic lesions were obtained from the reports. In two cases the fungi observed were not identified. The main diseases observed, in descending order of prevalence, were: pythiosis, candidiasis, aspergillosis, zygomycosis, dermatophytosis, mallasseziosis, cryptococcosis, megabacteriosis, and sporothrichosis. Others diseases with only one cases each were histoplasmosis and pneumocystosis. Pythiosis affected mainly horses and the mycosis affected mainly companion animals (dogs and cats).

Para determinar as principais micoses e oomicoses que acometeram animais domésticos na área de abrangência do Laboratório de Patologia Veterinária (LPV) da Universidade Federal de Santa Maria (UFSM), foi realizado um estudo retrospectivo em 9.487 protocolos de necropsias e 20.199 exames histopatológicos (totalizando 29.686 casos), realizados no LPV-UFSM, entre janeiro de 1990 e dezembro de 2012. Do total de protocolos analisados, 230 apresentaram micoses ou pitiose (oomicose), sendo 179 casos (78%) de micoses e 51 casos (22%) de pitiose. Os protocolos foram revisados para determinar os principais achados referentes à epidemiologia, sinais clínicos e às alterações macroscópicas e microscópicas. Em dois casos (0,8%) não foi possível determinar o gênero ou o grupo do fungo observado. As principais doenças diagnosticadas, em ordem decrescente de prevalência, foram: pitiose, candidíase, aspergilose, zigomicose, dermatofitose, malasseziose, criptococose, megabacteriose e esporotricose. Outras doenças diagnosticadas numa única ocorrência cada foram histoplasmose e pneumocistose. Os equinos foram os mais acometidos pela pitiose e os animais de companhia (cães e gatos) foram os mais acometidos pelas micoses.

Diagnóstico y tratamiento de dermatofitosis y pitiásis versicolor / Diagnosis and treatment of dermatophytosis and pityriasis versicolor

Antecedentes: Las micosis superficiales son una de las causas más frecuentes de consulta, tanto en los servicios de dermatología como en medicina general, ocasionando incomodidad y en algunos casos complicaciones, especialmente en pacientes diabéticos e inmunocomprometidos. Comprenden un grupo de afecciones comunes como dermatofitosis, candidiasis, pitiriasis versicolor, tiña negra y piedras. Fuente: se realizó una amplia revisión bibliográfica en las bases de datos de Hinari, Medline y Pudmed; con años de cobertura de 2001 a 2011. Desarrollo: con la presente revisión se pretende concientizar sobre la importancia del diagnóstico clínico y laboratorial específico de las micosis superficiales, para establecer el manejo pertinente en cada caso con la aplicación de la farmacológica y dosificación correcta.Conclusion: El diagnóstico de la mayoría de las micosis se realiza con la sospecha clínica y su comprobación a través del examen directo del material en fresco proveniente del sitio de la lesión y del aislamiento e identificación del hongo a partir del cultivo.

Pitiriasis versicolor por Malassezia pachydermatis: caso clínico / Pityriasis versicolor caused by Malassezia pachydermatis: clinical case

Se presenta un caso clínico de pitiriasis versicolor por M. pachydermatis en una paciente de 11 años de edad, diagnosticado mediante clínica, morfofisiología y biología molecular. Malassezia pachydermatis es parte de la microbiota común de diversos mamíferos domésticos y animales salvajes. En éstos se reconoce como agente causal de dermatitis y otitis externa. En humanos se han descrito escasas infecciones ya sea superficiales como invasoras, lo que puede atribuirse a la difícil transmisión y adaptación a partir de los animales domésticos. Se comentan los aspectos biológicos y epidemiológicos de esta infección zoonótica.

A clinical case of pityriasis versicolor caused by M. pachydermatis in an 11 year old patient which was diagnosed by means of clinic, morphophysiology and molecular biology is presented. Malassezia pachydermatis is part of regular microbiota in several domestic mammals as well as wild animals. It is recognized as the causing agent of dermatitis and external otitis in the latter. As to human beings, superficial infections have rarely been given an invasive character what can be explained by the difficult transmission and adaptation coming from domestic animals. Biological and epidemiological aspects of this zoonotic infection are described.

Lupus eritematoso cutáneo subagudo: reporte de un caso y revisión de la Literatura / Subacute lupus erythematosus cutaneous: report of a case and revision of the literature

El Lupus eritematoso cutáneo subagudo es una forma localizada e infrecuente de lupus eritematoso cutáneo. Afecta más a mujeres, generalmente durante la quinta década de la vida y en raras ocasiones aparece en la infancia. Las lesiones cutáneas son características pero muy variables en cuanto a su morfología,por este motivo sus diagnósticos diferenciales son diversos. El diagnóstico se basa en la correlación de los hallazgos clínicos e histopatológicos y la presencia de anticuerpos antiRo son confirmatorios. Se presenta el caso de una paciente femenina de 11 años de edad, sin antecedentes personales patológicos, con manifestaciones cutáneas e histopatológicas características de esta entidad y con anticuerpos Anti-Ro positivos, inicialmente tratada como micosis superficial...

Single dose fluconazole in the treatment of pityriasis versicolor

To evaluate the efficacy and safety of single dose [450mg] of fluconazole in the treatment of pityriasis versicolor. Patients suffering from pityriasis versicolor presenting to department of dermatology, Hayatabad Medical Complex, Peshawar were enrolled in the study. Diagnosis of PV was made by Wood`s lamp and confirmed by examination of scales in KOH preparation. 30 patients were included in the study. 30 patients completed the study including 24 males and 6 females. Their age ranged from 14 years to 45 years [mean 25.3 years]. Eighteen patients [60%] had complete cure and their clinical and laboratory parameters remained negative at 3 weeks and 6 weeks after completion of treatment. Twelve [40%] had no response to treatment. Treatment was well-tolerated and there were no adverse affects reported with single 450mg of fluconazole. Fluconazole 450mg as a single dose was effective in the treatment of pityriasis versicolor and well tolerated. However, long term comparative studies should be done to establish the efficacy of fluconazole as a single dose treatment in PV

Pityriasis versicolor in the pediatric age group.

BACKGROUND: Pityriasis versicolor (PV) is a mild chronic infection of the skin caused by Malassezia yeasts. Although it is primarily seen in adults, children are often affected in the tropics . METHODS: Over a period of 2 years, children (up to the age of 14 years) who were clinically and mycologically diagnosed as PV were included in the study. The clinical and epidemiological pattern in different age groups was noted. RESULTS: PV in this age group formed about 31% of the total cases of PV; 4.8% cases presented in infancy. The commonest site of involvement was the face in 39.9% of the cases. Most of the cases presented in summer months. CONCLUSIONS: PV is not an uncommon disease among children in the tropics. There is a sudden resurgence of cases in the hot monsoons and even infants are not spared.

Comparison of effectiveness between ketoconazole 2% and selenium sulfide 2.5% shampoos in the treatment of tinea versicolor

Tinea versicolor is a common superficial mycosis, which is caused by lipophilic yeasts, Malessezia furfur. It is a chronic and recurrent skin disease. It occurs most commonly in young post pubertal people and in hot and humid climates [north and south provinces of Iran]. Comparison of effects of ketoconazole 2% shampoo [Shafa Lab] with selenium sulfide 2.5% shampoo on tinea versicolor. Two-hundred patients with tinea versicolor were divided in 2 groups, each consisted of 100 patients, one group was treated with ketoconazole 2% shampoo and the other one with selenium sulfide 2.5% shampoo. We found out that ketoconazole 2% shampoo was more effective [89% cure rate] than selenium sulfide 2.5% shampoo [35% cure rate]. It seems that ketoconazole 2% shampoo is more effective than selenium sulfide 2.5% shampoo in the treatment of tinea versicolor

Treatment of pityriasis versicolor with two Weekly dose of systemic fluconazole

The application of systemic fluconazole in the management of Tinea versicolor is well distributed around the world. This treatment has recently began in our country. To study the effect of systemic fluconazole given orally once a week for two successive weeks in curing tinea versicolor and preventing recurrence. 35 patients with Tinea versicolor were treated with a single oral dose of fluconazole at the Department of Dermatology in Baghdad Teaching Hospital.The treatment were designed to give 300 mg as single dose to be repeated next week with 150 mg and followed up for one month. The treatment with single oral dose of fluconazole [300mg] cured 28 patients i.e. 80% of cases who were free of lesi. Systemic fluconazole therapy is very useful for chronic or extensive pitryiasis versicolor

Pityriasis versicolor in children A clinical study of 82 cases

Pityriasis versicolor [PV] is a superficial fungal infection that is uncommonly reported in children. Clinical diagnosis can be confirmed by mycological examination of scales collected by scraping of the lesion or by an adhesive tape. The objective of this study was to assess the frequency and the clinical features of PV in Iraqi children and to ascertain the diagnostic specificity of direct mycological examination. Patients and Eighty-two patients were included in the study during a 3-year period. The inclusion criteria included age less than 15 years, clinical diagnosis compatible with PV, and positive mycological diagnosis. Mycological examination was done for 82 age and sex matched patients with piryriasis alba or vitiligo as a control group. Children constituted 10.8% of all cases of PV seen in our department during the study period. The disease occurred mainly among older children. mean age 11.7 years. There was a slight female predominance. Family history was positive among 69.5% of the children. The disease presented mainly during the spring and summer months [70.7%]. The lesions occurred mainly on the face [51.2%]. The hypopigmented variant was predominant [71.9%]. The scraping test for fungus was negative in all control cases. PV occurs rarely among children, but the differential diagnosis of hypopigmented lesions on the face of a child should include this condition. Direct examination is a quick and easy test to confirm the diagnosis of the disease

Pustulosis neonatal por malassezia furfur: aporte de cuatro casos clínicos / Neonatal malassezia furfur pustulosis: 4 cases report

La pustulosis neonatal por Malassezia furfur es una erupción papulopustulosa no folicular de cara, cuero cabelludo y cuello que aparece en el primer mes de vida. Se presentan cuatro neonatos con lesiones clínicas de pustulosis por Malassezia furfur en los cuales se confirmó el diagnóstico por examen micológico directo del material obtenido de pústulas. Se realiza diagnóstico diferencial con otras pustulosis del recién nacido, particularmente con el acné neonatal. Se observó buena respuesta terapéutica al ketoconazol tópico en forma de crema al 2 por ciento, aplicada dos veces al día durante dos semanas

Micosis cutáneas y manifestaciones cutáneas de las micosis sistémicas en pacientes con SIDA / Cutaneous mycoses and cutaneous manifestations of systemic mycoses in AIDS

Las micosis cutáneas adquieren en los individuos con SIDA características particulares. Las diferencias observadas son debidas al déficit inmunológico presente en estos pacientes, sobre todo en la inmunidad celular, de vital importancia en el control de éstas y otras infecciones micóticas. Las lesiones suelen ser poco inflamatorias y extendidas a regiones donde no se ubican en individuos inmunocompetentes, además de ser recidivantes y notablemente resistentes a la terapéutica antifúngica específica. El agente causal más frecuente de las dermatoficias (tineas pedis, cruris y unguium) es Trichophyton rubrum, en las pitirosporosis (dermatitis seborreica, foliculitis y pitiriasis versicolor) Pityrosporum ovale y en las candidiasis Candida albicans. Otras micosis cutáneas, formas clínicas y agentes etiológicos, si bien probables, no son frecuentes en estos pacientes. El tratamiento de todas ellas es difícil, más aún teniendo en cuenta las numerosas interacciones medicamentosas con los diferentes esquemas terapéuticos que reciben los pacientes con SIDA. También las micosis sistémicas (en nuestro medios criptococosis e histoplasmosis) se manifiestan en la piel con lesiones papulosas o moluscoides, únicas o múltiples. Su reconocimiento permite el diagnóstico temprano de estas micosis. El propósito de este trabajo es describir algunas de las características clínicas, inmunológicas, diagnósticas y terapéuticas de las micosis cutáneas en los pacientes con SIDA