ABSTRACT
BACKGROUND: The aetiology of pityriasis alba (PA) remains uncertain, and children are at risk for PA and intestinal parasites. AIM: To determine the prevalence of intestinal parasites in PA patients and to evaluate their possible role in PA pathogenesis. METHODS: Overall, 180 PA patients and 100 healthy individuals were enrolled. Intestinal parasites were diagnosed by triple coproscopy, and the total serum Immunoglobulin E (IgE) levels were determined by ELISA. PA patients with intestinal parasites were treated with conventional antiparasitic drugs. Patient response to antiparasitic therapy was evaluated after 6 weeks. RESULTS: The prevalence of intestinal parasites in PA patients and controls was 60 ± 3.6% and 32 ± 4.6%, respectively (P < .0001). Regardless of the parasite species among the PA patients and control individuals, the total IgE levels were significantly higher in PA patients (P ≤ .05). The highest values of IgE were found in PA patients with Hymenolepis nana (641.7 ± 46.3 IU/mL). The total IgE level in PA patients with parasites decreased after antiparasitic therapy, but the reduction was only significant in patients with H. nana (P < .05). Complete disappearance of hypopigmented patches was observed after the elimination of H. nana, Giardia lamblia and Enterobius vermicularis in 65 ± 10.6%, 48.7 ± 8.0% and 33.3 ± 8.2% of cases, respectively. In total, a positive clinical response to antiparasitic therapy was achieved in 60 ± 4.7% of infected PA patients. CONCLUSION: A positive clinical response to antiparasitic therapy indicates the role of intestinal parasites in PA pathogenesis. Parasitological examination is justified by the recovery of 60 ± 4.7% of infected PA patients after the elimination of intestinal parasites.
Subject(s)
Feces/parasitology , Helminthiasis/parasitology , Helminths/isolation & purification , Intestinal Diseases, Parasitic/parasitology , Pityriasis/parasitology , Adolescent , Animals , Child , Child, Preschool , Female , Helminthiasis/epidemiology , Humans , Intestinal Diseases, Parasitic/epidemiology , Male , Pityriasis/epidemiology , Prospective Studies , Protozoan Infections/epidemiology , Thiazoles/therapeutic useSubject(s)
Microscopy, Confocal , Mite Infestations/diagnosis , Mites , Pityriasis/parasitology , Skin/pathology , Adult , Animals , Biopsy , Female , Humans , Mite Infestations/complications , Pityriasis/pathologyABSTRACT
Os autores descrevem as principais micoses superficiais na infância. Seus fatores predisponentes, agentes etiológicos, mecanismos de transmissão e o tratamento são discutidos.
Subject(s)
Humans , Male , Female , Child , Mycoses , Candidiasis, Cutaneous/diagnosis , Candidiasis, Cutaneous/drug therapy , Pityriasis/diagnosis , Pityriasis/parasitology , Pityriasis/drug therapy , Pityriasis/therapy , Tinea Capitis/diagnosis , Tinea Capitis/drug therapy , Child HealthABSTRACT
BACKGROUND: Patients with immunodeficiency are prone to infestation with Demodex folliculorum mites. Ultraviolet (UV) radiation can lead to immunosuppression and sebaceous gland hyperplasia. Although some cases of demodicidosis related to UV radiation exposure have been reported, no studies have been performed on the incidence of D. folliculorum and its clinical characteristics in patients receiving phototherapy. Objective To investigate the effects of phototherapy on the density of D. folliculorum infestation and its clinical characteristics. METHODS: This was a cross-sectional study. Forty-five patients receiving phototherapy and 43 age- and sex-matched healthy controls were enrolled to the study. The sociodemographic characteristics, occupational information, and skin types (2, 3, 4, or 5) of both patients and controls were carefully recorded. The dermatologic diseases requiring phototherapy, type and number of phototherapy treatments, and cumulative UV doses of all patients were noted. The clinical findings that may relate to demodicidosis were recorded. Standardized skin surface biopsies were taken from three anatomic regions (forehead, cheek, and nasal dorsum) and suspected lesions; five or more D. folliculorum mites per square centimeter of skin was defined as demodicidosis. RESULTS: Twelve (26.7%) patients received psoralen plus UV-A (PUVA) and 33 (73.3%) received narrow-band UV-B. Demodicidosis was detected in 13 (28.9%) patients and three (7%) controls. The difference in the demodicidosis rate between patients and controls was statistically significant (P = 0.01). In eight of the 13 patients (61.5%) with demodicidosis, clinical demodicidosis was present. Demodicidosis was present in seven of the 12 patients (58.3%) receiving PUVA and in six of the 33 patients (18.2%) receiving narrow-band UV-B. The difference in demodicidosis rates between patients receiving PUVA and those receiving narrow-band UV-B was statistically significant (P = 0.02). A statistically significant difference was also found between the mean D. folliculorum densities of patients and controls in all anatomic regions. CONCLUSION: Demodicidosis should be included in the differential diagnosis of facial eruptions in patients receiving phototherapy.
Subject(s)
Face/parasitology , Mite Infestations/etiology , Mites , Photochemotherapy/adverse effects , Phototherapy/adverse effects , Skin Diseases, Parasitic/etiology , Adolescent , Adult , Animals , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Mite Infestations/parasitology , Pityriasis/etiology , Pityriasis/parasitology , Psoriasis/therapy , Radiation Dosage , Rosacea/etiology , Rosacea/parasitology , Skin Diseases, Parasitic/parasitology , Statistics, Nonparametric , Vitiligo/therapyABSTRACT
Standardized skin surface biopsy (SSSB) is an appropriate method for measuring the density of Demodex folliculorum (Dd). Nevertheless, the observation of a clinical case demonstrates that, contrary to what was presumed before, a single SSSB can fail to collect the complete biotope of the mite. This could give rise to false negative results regarding the measurement of Dd.
