Pityriasis capitis: Causes, pathophysiology, current modalities, and future approach.

BACKGROUND: Pityriasis capitis commonly known as dandruff is one of the most common and widely seen dermatological disease that affects majority of the world population. It is more than superficial flaking, as it leads to significant structural changes in the stratum corneum and inflammatory biomarkers. Various intrinsic and extrinsic factors, such as Malassezia yeast, host epidermal conditions, sebaceous secretion, and abnormal immune responses, are found to contribute to the pathogenesis. Regardless of wide research, detail understanding, and treatment modalities, it still remains to be a cause of concern due to its recurring nature. AIMS: The objective of this study is to enhance the understanding of its wide causes, pathophysiology, current treatment, and future approach. METHODS: The article also aims at evaluating various promising anti-dandruff agents that can be further researched to become the leads in anti-dandruff therapy. RESULTS & CONCLUSION: The article summarizes the current knowledge on dandruff and present new facts and evidences in order to spread awareness, create potential for new herbal treatment options, and effectively control the most commercially exploited scalp disorder.

Pityriasis Folliculorum: Response to Topical Ivermectin

Pityriasis folliculorum has been described as a dry type of rosacea with extensive proliferation of Demodex folliculorum in pilosebaceous follicles of the skin. This skin condition is frequently difficult to manage, with various treatment options showing mixed efficacy. Oral ivermectin, a macrocyclic lactone parasiticide with anti-inflammatory and anti-parasitic effects, is one of the leading treatment modalities for demodicosis. Topical ivermectin has recently been FDA approved as therapy for rosacea. We present the case of a woman with pityriasis folliculorum who showed significant improvement from using topical ivermectin with no adverse events related to treatment.

Comparative efficacy of topical application of tacrolimus and clotrimazole in the treatment of pityriasis versicolor: A single blind, randomised clinical trial.

BACKGROUND: Pityriasis versicolor (PV) is a common superficial fungal disease. Possibility of emergence of resistant strains to azoles, and difficulty in differentiation of hypopigmented PV and early vitiligo, encouraged us to evaluate the efficacy of topical tacrolimus (a calcineurin inhibitor agent with proven in vitro anti-Malassezia effect) for PV treatment generally and its effect on PV-induced hypopigmentation specifically. OBJECTIVES: To evaluate the efficacy of topical tacrolimus on pityriasis versicolor. PATIENTS/METHODS: Fifty PV patients were randomly allocated into two equal groups applying either topical clotrimazol or tacrolimus twice daily for 3 weeks. They were evaluated at the beginning of study, in the third and fifth weeks clinically and mycologically (direct smear). RESULTS: Although both treatments resulted in global, clinical, and mycological cure of PV, there was no significant difference regarding the mentioned aspects of cure between tacrolimus and clotrimazole treated patients. (P-value: .63, .45, and .26, respectively) Tacrolimus had no significant effect on hypopigmentation in the fifth week follow-up. (P-value: .62). CONCLUSIONS: In spite of the lack of efficacy of tacrolimus on PV-induced hypopigmentation, the therapeutic effect on PV introduces tacrolimus as a therapeutic option for PV, especially when early vitiligo is among the differential diagnoses without concerning the aggravating effect of topical corticosteroids on PV.

Pityriasis amiantacea: a study of seven cases.

Pityriasis amiantacea was first described in 1832. The disease may be secondary to any skin condition that primarily affects the scalp, including seborrheic dermatitis. Its pathogenesis remains uncertain. We aim to analyze the epidemiological and clinical profiles of patients with pityriasis amiantacea to better understand treatment responses. We identified seven cases of pityriasis amiantacea and a female predominance in a sample of 63 pediatric patients with seborrheic dermatitis followed for an average of 20.4 months. We reported a mean age of 5.9 years. Five patients were female, with a mean age of 9 years. All patients were successfully treated with topic ketoconazole.

Psoriasis folicular, esa gran desconocida / Follicular Psoriasis, the great unknown

La psoriasis es una enfermedad cutánea crónica caracterizada más frecuentemente por placas eritematosas que aparecen normalmente con una distribución característica en superficie de extensión de extremidades, zonas de presión y cuero cabelludo. Aunque el diagnóstico diferencial de la psoriasis es amplio, el reconocimiento de esta entidad puede ser realizado mediante una correcta anamnesis y exploración física en la mayoría de los casos. La psoriasis folicular es una variante infradiagnosticada entre las diversas formas de psoriasis bien documentadas en la bibliografía (AU)

Psoriasis is a chronic skin disorder most commonly characterized by well-demarcated erythematous plaques with a typical distribution on extensor areas of limbs, pressure areas and scalp. Although the differential diagnosis of psoriasis is broad, its identification can be made by means of careful anamnesis and physical examination in the vast majority of cases. Follicular psoriasis is an under-diagnosed variant among the other well documented forms of psoriasis (AU)

A case of pityriasis amiantacea with rapid response to treatment.

Pityriasis amiantacea is a rare cutaneous reaction pattern to various underlying inflammatory diseases of the scalp. The clinical findings are very characteristic but often under-recognized. This condition can lead to scarring alopecia, and can be refractory to conservative treatment. It is therefore important to recognize the condition so that appropriate treatment can be initiated promptly.

Efficacy and tolerability of a cream containing AR-GG27® (sorbityl furfural palmitate) in the treatment of mild/moderate childhood atopic dermatitis associated with pityriasis alba. A double-blind, placebo-controlled clinical trial.

AIM: Pityriasis alba (PA) is a skin disorder characterized by finely scaly, hypopigmented patches, typical of childhood, that also represents an atopic dermatitis (AD) minor sign according to Hanifin and Rajka criteria. It may be isolated or associated with AD representing, sometimes an atypical manifestation of AD during the long-term follow-up of the disease. Aim of the study was to evaluate of the efficacy and tolerability of AR-GG27® (sorbityl furfural palmitate) cream in the treatment of childhood mild or moderate AD associated with PA. METHODS: The trial is a single center, double-blind, randomized, placebo-controlled study. The study included patients of both sexes, aged between two months and 15 years, suffering from mild and moderate AD always associated with PA. Xerosis was present in all patients. The treatment with topical steroids or topical calcineurin inhibitors (TIMs) had to be suspended for at least 15 days. Any systemic therapy and phototherapy or sun exposure were withdrawn at least 30 days before. Emollients were stopped at least seven days before. During the trial, no other local or systemic treatments were allowed, as well as sun exposure. Patients affected by AD with viral, bacterial or fungal overinfection or patients with diabetes mellitus, severe systemic diseases or intolerance to one or more components of the product were excluded. The primary endpoint was the evaluation of the average change in the Investigator Global Assessment (IGA) after 15 and 30 days of treatment. The second endpoint was the evaluation of severity of three different clinical signs: erythema, excoriation desquamation, using a subjective five-point scale. Changes in pruritus severity was also considered during the entire period of treatment, through the use of a Visual Analogue Scale (VAS). A P<0.05, two tailed was considered as statistically significant. RESULTS: After 15 and 30 days there was a statistically significant difference in the group treated with AR-GG27®, compared to the placebo (respectively, P=0.0007 and P=0.005). After 15 days of treatment, itching was clearly reduced in AR-GG27® treated group compared with the placebo, both in the study population (P=0.01) and in patients where the symptom was present from the beginning (P=0.05). CONCLUSION: AR-GG27® showed a beneficial action associated with high compliance and tolerability in dermatological skin conditions characterized by inflammation and tissue oxidative stress in children, as PA with mild and moderate AD.

Researching accessible and affordable treatment for common dermatological problems in developing countries. An Ethiopian experience.

BACKGROUND: Skin diseases are very common in rural and urban areas of Ethiopia, and traditional preparations of plant origin might represent the only alternative to synthetic drugs. Improving knowledge of traditional medicines and assessing their safety and effectiveness is necessary. METHODS: We conducted a two-arm, randomized, double-blind, placebo-controlled trial assessing the efficacy of some cosmetic herbal preparations for common dermatologic problems: a 3% thyme essential oil antifungal cream and a 10% chamomile extract cream for eczema-like lesions. RESULTS: Ten subjects (66.5%) treated with the 3% thyme active cream were completely healed vs. four subjects (28.5%) from the placebo group (P=0.040). A large number of subjects treated with the chamomile cream were healed or improved, but no significant differences were found between active cream and placebo. A high rate of treatment acceptance was registered in both groups, no adverse effects were reported. CONCLUSIONS: A 3% thyme essential oil cream could represent a cheap and easily available opportunity to treat and heal mild to moderate cases of fungal infections; a common emollient cream could be a very effective intervention when treating mild to moderate cases of pityriasis alba and eczema-like lesions. Further research is needed.

Micoses superficiais na infância / Superficial mycoses in childhood

Os autores descrevem as principais micoses superficiais na infância. Seus fatores predisponentes, agentes etiológicos, mecanismos de transmissão e o tratamento são discutidos.