RESUMO
@#<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>
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Cetoconazol , Itraconazol , Fluconazol , Tinha Versicolor , Pitiríase , Revisão Sistemática , MetanáliseRESUMO
No abstract available.
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Humanos , Ceratodermia Palmar e Plantar , Pitiríase Rubra Pilar , Pitiríase , IrmãosRESUMO
No abstract available.
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Adulto , Humanos , Acrodermatite , Pitiríase Rubra Pilar , Pitiríase , ZincoAssuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Pitiríase/tratamento farmacológico , Terapia PUVA/métodos , Vitiligo/tratamento farmacológico , Fatores de Tempo , Reprodutibilidade dos Testes , Resultado do Tratamento , Dermatoses Faciais/tratamento farmacológico , Pessoa de Meia-IdadeRESUMO
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.
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Adulto , Humanos , Braço , Biópsia , Dermatomicoses , Itraconazol , Malassezia , Pitiríase Rubra Pilar , Pitiríase , Análise de Sequência , Pele , Tinha Versicolor , Tinha , Extremidade SuperiorRESUMO
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.
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Adulto , Humanos , Biópsia , Diagnóstico , Micose Fungoide , Fototerapia , Pitiríase Liquenoide , Pitiríase , Prognóstico , PeleRESUMO
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.
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Adulto , Criança , Humanos , Classificação , Derme , Eritrócitos , Coreia (Geográfico) , Necrose , Pitiríase Liquenoide , Pitiríase , Estudos Retrospectivos , PeleRESUMO
No abstract available.
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Metotrexato , Pitiríase Liquenoide , Pitiríase , PrednisolonaRESUMO
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. .
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Feminino , Humanos , Masculino , Dermatite Atópica/patologia , Fator XIIIa/análise , Células de Langerhans/patologia , Pitiríase/patologia , Biópsia , Estudos Transversais , Progressão da Doença , Imuno-Histoquímica , Curva ROC , Estatísticas não Paramétricas , Pele/patologiaRESUMO
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.
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Dermatologia/métodos , Humanos , Hipopigmentação/patologia , Líquen Escleroso e Atrófico/patologia , Patologia Clínica/métodos , Pitiríase/patologia , Vitiligo/patologiaRESUMO
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.
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Humanos , Pitiríase/patologia , Dermatoses do Couro Cabeludo/patologia , Dermoscopia , Cabelo/patologiaRESUMO
BACKGROUND: Skin pigmentary changes of pityriasis versicolor may occur as either hyperpigmented or hypopigmented lesions, depending on the outcome of interactions between Malassezia yeasts and the skin, such as lipoperoxidation process, stimulus of inflammatory cell to melanocytes, and increased thickness of keratin layer. OBJECTIVE: To investigate skin characteristic factors that enhance the susceptibility to Malassezia yeasts and provoke different color changes of pityriasis versicolor patients. METHODS: To clarify these factors, we investigated the skin characteristics of pityriasis versicolor patients, using a non-invasive method known as MPA 5(R) (Courage and Khazaka, Germany). A total of 90 normal healthy subjects and 30 pityriasis versicolor patients were included in this study. RESULTS: Both hyperpigmented and hypopigmented pityriasis versicolor skin lesions showed higher humidity, increased sebum excretion rate and increased transepidermal water loss (TEWL) values than normal healthy subjects. But no significant difference of specific Malassezia yeasts species between hyperpigmented and hypopigmented skin lesions was evident. CONCLUSION: These results indicate that higher humidity and increased sebum level provide a better growing environment of Malassezia yeasts in the skin, leading to the assumption that interaction between Malassezia yeasts and skin barrier materials makes disruption of skin barrier causing increased TEWL.
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Humanos , Umidade , Queratinas , Malassezia , Melanócitos , Pitiríase , Sebo , Pele , Tinha Versicolor , Perda Insensível de Água , LevedurasRESUMO
Pityriasis versicolor is a superficial infection of the stratum corneum, which is caused by the Malassezia species. Tge Malassezia species consist of 12 subspecies, including M. furfur, M. pachydermatis, M. symphodialis and M. globasa. The Malassezia species are classified as a normal flora, particularly in the sebum rich areas of the skin, and they convert from saprophytic yeast to parasitic mycelial morpholgic form to cause clinical disease. But majorities of their distributions are in the upper back, the neck, the thighs, and the forearm, and not in the penis. It is well known that the renal transplant patients, who take immunosuppressive agents, have impairment in the protective cell mediated immunity. Thus, they are more susceptible to infectious diseases, such as a fungal infection. Therefore, clinical manifestations show higher incidence of disease, but they mostly occur in an expected distribution. We here report a case of pityriasis versicolor in a renal transplant recipient on penile shaft, which is an unusual area.