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PubMed2001

Cell-mediated immunity to the mycelial phase of Malassezia spp. in patients with pityriasis versicolor and controls.

BACKGROUND: Malassezia is the aetiological agent of pityriasis versicolor. The mycelial phase of the organism predominates in lesions of pityriasis versicolor. OBJECTIVES: To evaluate the cell-mediated immune (CMI) response to the mycelial phase of Malassezia in patients with this disease, which has not previously been studied. METHODS: The CMI status of 12 patients with pityriasis versicolor and 12 age- and sex-matched controls to mycelial antigen(s) of the organism was examined. The responses to the mycelial form of three strains of the organism were assessed using lymphocyte transformation and leucocyte migration inhibition assays. RESULTS: The transformation responses of the lymphocytes from both patients and controls gave transformation indices < or = 3, although the responses of lymphocytes from patients with pityriasis versicolor to the mycelial form of Malassezia strains were generally higher than those of the controls. In the leucocyte migration inhibition assay, leucocytes from patients with pityriasis versicolor and controls responded to the mycelial antigens of three different Malassezia strains; however, there was no significant difference in leucocyte response between patients with pityriasis versicolor and controls. CONCLUSIONS: Patients with pityriasis versicolor do not therefore have a CMI deficiency to Malassezia mycelial antigens but fail to generate a protective CMI response to mycelial antigens over and above that of control individuals during active disease.

Adult↗
PubMed2002

Pityriasis rosea is associated with systemic active infection with both human herpesvirus-7 and human herpesvirus-6.

Pityriasis rosea is a common skin disease that has been suspected to have a viral etiology. We performed nested polymerase chain reaction to detect human herpesvirus-7, human herpesvirus-6, and cytomegalovirus DNA in lesional skin, nonlesional skin, peripheral blood mononuclear cells, serum, and saliva samples isolated from 14 pityriasis rosea patients. Viral mRNA expression and virion visualization within lesional skin were studied by in situ hybridization and transmission electron microscopy, respectively. By nested polymerase chain reaction, human herpesvirus-7 DNA was present in lesional skin (93%), nonlesional skin (86%), saliva (100%), peripheral blood mononuclear cells (83%), and serum (100%) samples, whereas human herpesvirus-6 DNA was detected in lesional skin (86%), nonlesional skin (79%), saliva (80%), peripheral blood mononuclear cells (83%), and serum (88%) samples. By contrast, cytomegalovirus DNA was not detected in these tissues. Control samples from 12 healthy volunteers and 10 psoriasis patients demonstrated rare positivity for either human herpesvirus-7 or human herpesvirus-6 DNA in skin or serum. By in situ hybridization, infiltrating mononuclear cells expressing human herpesvirus-7 and human herpesvirus-6 mRNA were identified in perivascular and periappendageal areas in 100% and 75% pityriasis rosea skin lesions, respectively, compared to herpesviral mRNA positivity in only 13% normal skin and psoriasis skin controls. Transmission electron microscopy failed to reveal herpesviral virions in pityriasis rosea lesional skin. Nested polymerase chain reaction and in situ hybridization enabled detection of human herpesvirus-7 and human herpesvirus-6 in skin and other tissues isolated from patients with pityriasis rosea. These results suggest that pityriasis rosea is associated with systemic active infection with both human herpesvirus-7 and human herpesvirus-6.

Adolescent↗
PubMedDate not supplied

Pityriasis rotunda in childhood.

Pityriasis rotunda is a rare disease characterized by round or oval patches, localized mainly on the trunk, arms, and legs. The patches are usually lighter than the surrounding skin, but sometimes may be darker, and are covered by fine, adherent scales. Two types of pityriasis rotunda have been described. Type I has been observed mainly in oriental and black patients older than 60 years of age, and is often associated with systemic disease or malignancy. Type II has been observed in white patients younger than 40 years of age, is often familial, and has never been observed in association with malignancy or internal disease. On Sardinia, a cluster of patients with type II pityriasis rotunda has been described. From 1981 until 1998, 51 cases of this disease have been observed in the Department of Dermatology, University of Sassari; 32 of them were children. The great prevalence of pityriasis rotunda on Sardinia, an island which until 40 years ago had limited contact with the Italian mainland, and the presence of a large number of familial cases suggest that type II pityriasis rotunda should be considered a genetically determined disease. The trend toward spontaneous resolution after the age of 20 years suggests that pityriasis rotunda should be considered a genodermatosis with a temporary phenotypic expression.

Adolescent↗
PubMed2002

Cytotoxic mycosis fungoides evolving from pityriasis lichenoides chronica in a seventeen-year-old girl. Report of a case.

Pityriasis lichenoides chronica and its acute form, pityriasis lichenoides et varioliformis acuta, are skin diseases of unknown origin, that probably represent a hypersensitivity reaction to an infective agent. Pityriasis lichenoides is often a benign disorder but, because of the presence of a clonal T cell population detected both in the chronic and acute forms, some authors have suggested that it may belong to the group of primary cutaneous T cell lymphomas. Although various studies have clearly documented no significant association between pityriasis lichenoides and malignant lymphomas, cases of long-standing pityriasis lichenoides evolving into mycosis fungoides have been described. Herein we report the case of a girl suffering from pityriasis lichenoides since the age of 11 years, subsequently developing a CD45RO+, CD8+, TIA-1+ mycosis fungoides.

Adolescent↗
PubMed1975

Predisposing factors on the surface of the skin in persons with pityriasis versicolor.

This is a report on biochemical and physiological examinations carried out on 20 test persons who in the last 2 years had contacted and completely recovered from pityriasis versicolor and on 25 control persons of corresponding age and sex. The tests on the skin surface of the patients with pityriasis versicolor show, when compared with the corresponding control group, the following significant results: 1. Significantly more amino acids could be extracted from the skin of the pityriasis versicolor patients than from the skin of the control persons. 2. A significantly shorter alkali neutralisation time was to be found in the pityriasis versicolor patients than in the control persons. 3. The degree of water spreading on the skin was found to be significantly reduced in the pityriasis versicolor patients when compared with the control persons. It is probable that these results point to important predisposing factors for pityriasis versicolor.

Adult↗
PubMed2003

Intertriginous lesions in pityriasis versicolor.

BACKGROUND: The well-recognized sites of involvement in pityriasis versicolor are the upper part of the trunk, the neck and the upper arms. There is little documentation regarding pityriasis versicolor lesions in flexural areas. OBJECTIVES: To study the occurrence and morphology of lesions of pityriasis versicolor in flexural areas. METHODS: One hundred and ten cases of pityriasis versicolor were studied. Sites of lesions and other clinical features were determined. RESULTS: Flexural lesions in pityriasis versicolor were not uncommon. They were not correlated to age, sex, duration or relapses of the infection. CONCLUSION: Thorough inspection and examination of the skin by Wood's light before establishing treatment is prudent in cases of pityriasis versicolor located in typical sites.

Adult↗
PubMed2005

Pityriasis versicolor alba.

Pityriasis versicolor alba is a hypopigmented or depigmented variant of pityriasis versicolor characterized by maculous, partly pityriasiform, scaly depigmented lesions occurring particularly in seborrhoeic areas. Long-persisting hypopigmentation after healing of the pityriasis versicolor was first described by Gudden in 1853. Hypopigmentation and depigmentation were later differentiated as an independent variant of the disease. In 1848, Eichstedt recognized the pathogen-related character of pityriasis versicolor in its hyperpigmented form. Today it is generally accepted that the disease is caused by yeasts of the genus Malassezia, of which nine species are differentiated. It is controversial whether a single species is responsible for the disease. The pathogenesis of depigmentation has not been established. A screening effect by the scale layer as well as toxic effects on pigment synthesis by fungal metabolites have been discussed. With regard to the second mechanism, the newly discovered tryptophan-derived metabolites of M. furfur might be significant. Evidence-based data concerning the therapy of pityriasis versicolor alba do not exist. According to current recommendations, pityriasis versicolor should be rapidly treated with antimycotics, followed by ultraviolet therapy to induce maturation of existent melanosomes and accelerate repigmentation. However, depigmented lesions are difficult to improve by ultraviolet therapy.

Antifungal Agents↗
PubMed1999

Pityriasis rosea is not associated with human herpesvirus 7.

OBJECTIVE: To examine the proposed association between pityriasis rosea and human herpesvirus 7 (HHV-7). DESIGN: A retrospective cross-sectional survey. SETTING: University medical center in Switzerland. PATIENTS: Thirteen patients with pityriasis rosea and 14 persons with normal skin (control subjects). MAIN OUTCOME MEASURES: Detection of HHV-7-specific DNA sequences and antigen (85-kd phosphoprotein [pp85]) by nested polymerase chain reaction and immunohistochemical analysis, respectively. RESULTS: Human herpesvirus 7 DNA sequences and expression of the HHV-7-specific immunodominant pp85 antigen were found in 1 (8%) of 13 lesional skin biopsy specimens of pityriasis rosea. The prevalence of HHV-7 DNA sequences and antigens is even slightly lower in lesional skin of patients with pityriasis rosea than in clinically and morphologically normal skin of 14 control persons, in 2 of whom (14%) HHV-7 DNA sequences and antigens could be detected. CONCLUSION: The low detection rate of HHV-7 DNA sequences and antigens argues strongly against a causative role for HHV-7 in the pathogenesis of pityriasis rosea.

Adolescent↗
PubMed2003

Case clustering in pityriasis rosea: a multicenter epidemiologic study in primary care settings in Hong Kong.

OBJECTIVES: To investigate the epidemiology of pityriasis rosea in primary care settings in Hong Kong and to analyze for temporal clustering. DESIGN: Retrospective epidemiologic study. SETTING: Six primary care teaching practices affiliated with a university. Patients Forty-one patients with pityriasis rosea, 564 patients with atopic dermatitis (negative control condition), and 35 patients with scabies (positive control condition). METHODS: We retrieved all records of patients with pityriasis rosea, atopic dermatitis, or scabies diagnosed in 3 years. We analyzed temporal clustering by a method based on a regression model. RESULTS: The monthly incidence of pityriasis rosea is negatively but insignificantly correlated with mean air temperature (gamma s = -0.41, P =.19) and mean total rainfall (gamma s = -0.34, P =.27). Three statistically significant clusters with 7, 6, and 7 cases were identified (P =.03), occurring in the second coldest month in the year (February), the second hottest month (July), and a temperate month (April), respectively. For atopic dermatitis (negative control condition), the nonclustering regression model was selected by Akaike information criteria. For scabies (positive control condition), 1 cluster of 20 cases was detected (P =.03). CONCLUSIONS: Significant temporal clustering independent of seasonal variation occurred in our series of patients with pityriasis rosea. This may be indicative of an infectious cause.

Adolescent↗
PubMed1995

Pityriasis rosea Gibert: detection of Legionella micdadei antibodies in patients.

Some epidemiological and clinical characteristics of Pityriasis rosea Gibert has led us to hypothesize that this disease may be the clinical manifestation of an infection caused by legionellas. We have thus tested the sera of 36 patients ill with Pityriasis rosea and 19 controls for Legionella pneumophila serogroup 1-6 and Legionella micdadei antibodies. These, who had the same age and sex distribution as study patients, were receiving treatment for other diseases in the same ward. Also tested were 200 sera from the voluntary blood donors from the same region as study patients. Legionella micdadei antibodies were detected in 12 (33.3%) Pityriasis rosea cases and in one (5.2%) control. They were significantly more common in Pityriasis rosea cases than in either controls or voluntary blood donor population. The findings to date encourage continued research into the causative relationship between the Legionella micddadei infection and the onset of Pityriasis rosea Gibert.

Antibodies, Bacterial↗
PubMed1989

Pityriasis rubra pilaris: a review of diagnosis and treatment.

The diagnosis of pityriasis rubra pilaris is based essentially on characteristic clinical features. Although the histologic features are not pathognomonic, a lesional skin biopsy for evaluation is important to rule out other papulosquamous and erythematous disorders. The presence of prominent seborrheic keratoses occurring in two cases of pityriasis rubra pilaris is presented. Our understanding of the relationship between vitamin A metabolism and pityriasis rubra pilaris is discussed. Currently available systemic therapeutic modalities for pityriasis rubra pilaris are reviewed. Although pityriasis rubra pilaris does not represent a vitamin A deficiency state, it is responsive to isotretinoin, etretinate, and vitamin A. Antimetabolites remain an alternative therapy.

Aged↗
PubMed2002

Human herpes virus-like particles in pityriasis rosea lesions: an electron microscopy study.

BACKGROUND: In a previous study we detected virions with electron microscopy features of human herpes viruses in the supernatant of cocultured mononuclear cells from patients with acute pityriasis rosea. Because of their morphology and of polymerase chain reaction studies, we ascribed them to human herpes virus 7. OBJECTIVE: To find such virions in the lesional skin of pityriasis rosea patients. METHODS: Skin specimens from lesions of 21 patients with acute pityriasis rosea were examined by elecron microscopy. RESULTS: In 15 (71%) patients, human herpes virus particles in various stages of morphogenesis were detected. Mature enveloped virions appeared as typical human herpes virus virions, measuring about 160-200 nm in diameter and containing an electrodense cylindrical core, a capsid, an envelope with typical spikes and a very distinct tegument layer between the capsid and the envelope. They were very similar to those we reported in the supernatant of co-cultured circulating mononuclear cells from patients with pityriasis rosea. CONCLUSION: Our results confirm our previous findings and provides further evidence of a viral etiology for pityriasis rosea.

Herpesvirus 7, Human↗
PubMed2004

Clinical and mycological evaluation of therapeutic effectiveness of Solanum chrysotrichum standardized extract on patients with Pityriasis capitis (dandruff). A double blind and randomized clinical trial controlled with ketoconazole.

Dandruff (also called Pityriasis capitis) is a seborrhoeic dermatitis of the scalp. It has been correlated with the pathological colonization of the scalp with yeast from the genus Malassezia; this illness has a worldwide distribution and represents 25% of all scalp dermatosis cases. It has been demonstrated that the extract obtained from leaves of the plant Solanum chrysotrichum possesses biological activity against dermatophytes and yeast. Different steroidal saponins with antimycotic activity have been isolated from the active extract. Clinical trials with standardized extracts prepared with this vegetal species report high rates of clinical and mycological effectiveness in the treatment of Tinea pedis,without producing secondary effects. The aim of this randomized, double blind and controlled clinical study, was to compare the therapeutic effectiveness and tolerability of a shampoo containing a standardized extract of S. chrysotrichum (applied every third day, for 4 weeks), against 2% ketoconazole in the topical treatment of Pityriasis capitis. From a total of 120 patients with the clinical diagnosis of Pityriasis capitis, 14 subjects were eliminated because the presence of Malassezia was not proved, an-other two patients withdrew from the study due to non-medical causes and one more withdrew because Tinea capitis was diagnosed. Therefore, the final analysis included 51 subjects in the experimental group and 52 in the control; in 45.6% of the cases M. furfur was identified as the pathogenic agent, in 44.66% M. globosa was isolated, and 9.71 % of the patients had a mixed infestation. At the end of the treatment period, the prepared phytopharmaceutical with the standardized extract from S. chrysotrichum achieved a clinical effectiveness (total absence of signs and symptoms produced by Pityriasis capitis) of 92.16%;the mycological effectiveness (absence of Malassezia spp. in the direct examination and culture) was 68.63 %; whilst the tolerability (absence of side effects that prompt subjects to abandon the treatment) was 100%. The therapeutic success (clinical and mycological effectiveness plus tolerability) was 64.71%. The comparison of these results with that obtained from the group treated with 2% ketoconazole, showed no significant differences (Z2, p >0.23). These results show the therapeutic effectiveness and tolerability of the standardized extract from S. chrysotrichum on the local treatment of Pityriasis capitis associated with the yeast of the genus Malassezia.

Adolescent↗
PubMed1986

Pityriasis rotunda in a white patient. Report of the second case and review of the literature.

A 19-year-old white woman with pityriasis rotunda in whom no diagnosable disorder could be demonstrated is reported on herein. Pityriasis rotunda has been described in Oriental and black patients, usually in association with certain serious systemic diseases. Our patient appeared to have the second reported case of pityriasis rotunda in white persons. In both cases the dermatosis occurred in an otherwise healthy individual. Physicians should be alert to the possible occurrence of pityriasis rotunda in white patients. The literature on pityriasis rotunda is reviewed.

Adult↗
PubMed1980

[Idiopathic eruptive macular pigmentation following pityriasis rosea. Presentation of two cases (author's transl)].

We describe two cases of acquired hyperpigmented macular eruption following pityriasis rosea. This condition is characterized by an eruption of discrete grayish macules on the trunk. On the back, the lesion are oval and their long axis follows the cutaneous liners. Similar features have been described by Runtova. The clinical type of this pigmented eruption is quite comparable to the cases recently described by Degos, Civatte and Belaïch under the title of "idiopathic eruptive macular pigmentation". Sometimes the "idiopathic" character of this pigmented eruption may be lacking, when a retrospective diagnosis of lichen planus or pityriasis rosea can be made. We think that the pigmentogenes pityriasis rosea should be included in the group of atypical pityriasis rosea. A survey of the literature allows to recognize some identical cases formerly reported under various titles. All these cases should be grouped together under the title of pigmentogenes pityriasis rosea.

Adult↗
PubMed1997

The transformation of pityriasis lichenoides chronica into parakeratosis variegata in an 11-year-old girl.

Parakeratosis variegata is a rare disorder with unknown aetiology. In a few cases it arises from benign skin diseases such as pityriasis lichenoides et varioliformis acuta (Mucha Habermann disease) or pityriasis lichenoides chronica. However, transformation into malignant diseases such as cutaneous T-cell lymphoma has been observed. We report an 11-year-old girl with a 10-year history of pityriasis lichenoides chronica now presenting with parakeratosis variegata. Analysis of skin infiltrating T cells showed clonally rearranged T-cell receptor gamma chains occurring with a frequency of more than 2%. This finding is compatible with the clinical observation of parakeratosis variegata transforming into a malignant T-cell disorder. We therefore suggest that patients suffering from parakeratosis variegata and other diseases such as pityriasis lichenoides et varioliformis acuta or pityriasis lichenoides chronica should be continuously monitored.

Child↗
PubMed2002

Isolation of Malassezia globosa and M. sympodialis from patients with pityriasis versicolor in Spain.

Pityriasis versicolor is a superficial infection of the stratum corneum by several yeast species formerly collectively named Malasseziafurfur. The genus Malassezia has been recently enlarged with new species. With the exception of M. pachydermatis, the remaining six species have an absolute requirement in vitro for supplementation of long-chain fatty acids in media. These lipophilic yeasts comprise six species: M. furfur, M. globosa, M. obtusa, M. restricta, M. slooffiae and M. sympodialis. The aim of this study was to establish whether there was any association between the various species of Malassezia and pityriasis versicolor lesions. Thus, we studied the isolates from 79 patients with pityriasis versicolor, both from lesions and from apparently healthy skin close to the visible lesions. In pityriasis versicolor lesions, the species most frequently isolated was M. globosa (90%), followed by M. sympodialis (41%). Almost all isolates (99%) belonged to one of these two species. The most frequent pattern was M. globosa as the sole species (58% of cases), although the association with M. sympodialis was also frequent (30%). These results confirmed M. globosa as the main agent of pityriasis versicolor and M. sympodialis as the second agent in importance. Malassezia globosa was found to be a species with high levels of esterase and lipase enzymes of probable importance in their pathogenicity.

Adolescent↗
PubMed2005

[Missing granulocytic infiltrate in pityriasis versicolor--indication of specific anti-inflammatory activity of the pathogen?].

The yeast Malassezia furfur is a part of the resident flora of human skin. It causes various diseases such as pityriasis versicolor, which hardly shows signs of inflammation despite marked clinical symptoms (e.g. hypopigmentation). The pathophysiology related morphological picture might give a clue to this phenomenon. As a part of the literature data are controversial, the present study compared the inflammatory infiltrate of pityriasis versicolor with that of tinea corporis in 40 human skin preparations each from diagnostic specimens. All preparations were stained with HE and PAS. Neutrophilic granulocytes were counted in the HE stain, and hyphae and spores in the PAS stain. The number of counted cells was related to the size of the respective area and the values were compared between pityriasis and tinea corporis. Significantly, more neutrophilic granulocytes were found with tinea corporis (P > 0.01), while they were virtually not demonstrable with pityriasis versicolor. It is surprising that fungal load in the stratum corneum is significantly higher with pityriasis versicolor (P > 0.01). Obviously the immune response involving neutrophilic granulocytes does not occur despite high bacterial load. This might be explained by reduced immunogenicity because of high content of lipids in the cell membrane. Furthermore, pityriarubins that are produced during tryptophan metabolism might be involved, which, in a stimulus-dependent manner, can suppress the ROS production of neutrophilic granulocytes in vivo.

Colony Count, Microbial↗