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PubMed1986

A comparison between one and two weeks' treatment with bifonazole in pityriasis versicolor.

The mycologic and clinical efficacy and the local tolerance for 1 and 2 weeks of once-daily treatment of sixty cases of pityriasis versicolor with bifonazole 1% cream were studied in a biometrically planned, controlled, double-blind group comparison. The mycologic findings after 2 weeks were negative in all the patients, with the exception of one from the 1-week group. Two weeks later the findings were negative in each case. The evolution of the clinical symptoms was similarly good: after 2 weeks, only two patients in the 2-week group still exhibited scaling. In one case the pruritus, which had disappeared in the course of treatment, reappeared 2 weeks later. The mycosis began to improve within the first week, except in two patients in the 2-week group and one patient in the 1-week group.

Adult↗
PubMed2003

Pityriasis versicolor.

Pityriasis versicolor is a mild or chronic condition characterized by scaly hypopigmented or hyperpigmented lesions usually affecting the trunk. The lesions vary depending on tropical or temperate climates. The disease seems to occur mainly at adolescence when the sebaceous glands are more active. Malassezia yeasts have been implicated in the pathogenesis of this disease. The mycelial form of the fungus has been suggested to be the cause of lesions. Antifungal preparations have been used to treat the initial presentation effectively, although in a proportion of patients the disease tends to reoccur. They are available in a wide range of formulations and have been shown to be safe.

Administration, Cutaneous↗
PubMed1997

Humoral immune response to Malassezia furfur in patients with pityriasis versicolor and seborrheic dermatitis.

Humoral immune responses against exoantigen components of oval, elliptic and round yeast forms of Malassezia furfur were analysed by ELISA and Western blotting assays, using sera from patients with pityriasis versicolor (PV), seborrheic dermatitis (SD) and healthy adults (HA), as control. Sera from patients with SD showed IgG anti-oval M. furfur titers ranging from 1/400 to 1/6400 showing geometric mean (GM) of 1/1472, higher than those obtained with sera from patients with PV (1/200 to 1/6400, GM = 1/1239). Both patient groups showed mean titres statistically superior (P < 0.05) than those obtained form HA (GM = 1/229). Similar data were also obtained with the elliptic and round antigens. However, the anti-oval IgG mean titers from patients' sera were much higher than those obtained with elliptic or round antigenic components (p < 0.05) Anti-M furfur IgM titers obtained from patient's sera with PV against all three exoantigens were statistically superior (p < 0.05) than HA group. Patients with SD showed IgM titers statistically superior (p < 0.05) only to oval yeasts of M. furfur. The IgA mean titers from patients' groups against the different morphological antigens were shown be slightly higher than those HA group. By Western blot, using rabbit anti-sera, the different antigenic components of M.furfur showed a close relationship mainly between oval and elliptic yeast cells antigens. The 70 kDa component of the M. furfur exoantigen of oval morphology was recognized by 84% of the PV patients' sera. On the other hand, SD patients' sera recognized 3 principal components of 70 kDa (100%), 65 kDa (67%) and 84 kDa (53%). These components may be considered immunological markers for PV and SD. Twenty-five percent of HA sera recognized the components of 65, 70 and 94 kDa. This investigation shows that M. furfur antigens can sensitize the host, mainly the oval yeast form of M. furfur with a very important specific IgG response in patients with SD and PV.

Antibodies, Fungal↗
PubMed1997

Unusual observations in the histology of Pityriasis versicolor.

Histological studies were carried out on 25 patients with various morphological types of pityriasis vesicolor. In addition to the usual features, acanthosis nigricans-like picture in papular lesions, dilated blood vessels in erythematous lesions were observed. In sections stained with Periodic acid Schiff's stain (PAS) absence of granular layer in areas of close approximation of filaments to the stratum malpighii and presence of only mycelia in the vicinity of acrosyringium were found unusual, interesting and are new findings to our knowledge.

Adult↗
PubMed2000

Malassezia globosa as the causative agent of pityriasis versicolor.

BACKGROUND: The taxonomic revision carried out in 1996 on the genus Malassezia, which now comprises seven different species, made necessary a re-evaluation of the data concerning the ecology and pathogenicity of these lipophilic yeasts. Very little has been published since then. OBJECTIVES: The aim of this work was to contribute to the knowledge of the aetiology of pityriasis versicolor (PV) with a mycological study made according to the new species. METHODS: Ninety-six patients with PV completed the study. In all of them, samples were taken from the lesions for direct microscopy with KOH+ Parker ink and culture. Samples were also taken from normal skin of the trunk and the forehead of the same patients for culture. Cultures were made in modified Dixon medium in Petri dishes, incubated at 31 degrees C and the isolates were identified by morphological and physiological characteristics. RESULTS: In the PV lesions, direct microscopy always showed the typical mixture of globose blastoconidia and pseudomycelium. Only one patient, having received previous topical antimycotic treatment, was negative. The spherical yeasts observed in vivo were morphologically identical to the globose yeasts characteristic of M. globosa. In culture, M. globosa was found in 97% of cases, alone in 60% of them and associated with M. sympodialis in 29% and M. slooffiae in 7%. These two species were also found in similar percentages on the clinically uninvolved skin of the trunk, whereas M. globosa was not isolated at these sites. However, on the forehead, a small number of colonies of M. globosa was recovered in 12% of cases. CONCLUSIONS: These results support the data previously reported and strongly suggest that M. globosa in its mycelial phase is the causative agent of PV.

Adolescent↗
PubMed1991

Pityriasis versicolor in the Central African Republic: a randomized study of 144 cases.

The prevalence and the principal epidemiological characteristics of pityriasis versicolor have been studied in a randomized population of 870 adult individuals (418 males and 452 females) in the Central African Republic. The general clinical prevalence was 16.6%. Males were affected more often than females (20.6% vs. 12.9%). For both sexes, the maximum prevalence was in the 15 to 25-year-old age groups (23.5%). Lesions commonly occurred over the face (49.3%) and upper trunk (48.6%). Different climatic areas within the country, type of urbanization, religion and general hygiene showed no relevance to the disease. The prevalence was higher among people living in rammed-earth houses than in people living in hard-built houses. The sebaceous activity of the skin, a feature which is racially and genetically determined, probably constitutes a primary factor for developing this mycosis, associated with the tropical climate as an additional environmental factor.

Adolescent↗
PubMedDate not supplied

Randomized comparative clinical trial of itraconazole and selenium sulfide shampoo for the treatment of pityriasis versicolor.

Forty patients with pityriasis versicolor, fluorescence of involved areas under Wood's light, and positive microscopic identification of Malassezia furfur were randomly assigned to treatment with either oral itraconazole (200 mg once daily for five consecutive days) or 2.5% selenium sulfide shampoo (once daily application for seven days). Each treatment group consisted of 20 patients. On assessment three weeks after the end of treatment, all patients given itraconazole showed a response: 17 were healed, and three had mild residual lesions. Likewise, all patients in the selenium sulfide group responded to therapy: 16 were healed, and four had mild residual lesions. Tolerability, acceptability, and compliance were excellent with itraconazole. All 20 patients given the drug stated a preference for oral treatment. In the selenium sulfide group, five patients (25%) had adverse reactions attributable to the medication; one of these patients experienced an irritation severe enough to warrant the discontinuation of treatment on the third day. Ten patients in this group stated a preference for oral treatment.

Administration, Oral↗
PubMedDate not supplied

Pityriasis versicolor: efficacy of two five-day regimens of itraconazole.

An open, comparative trial of two brief regimens of itraconazole for pityriasis versicolor was carried out. Twenty-four patients received 100 mg twice a day for five days, and 23 received 100 mg once a day for five days. Patients were enrolled in the study on the basis of the presence of clinical symptoms and positive findings on direct microscopic examination. Tolerance to the drug and mycologic and clinical outcome were assessed on days 6, 14, and 28 after the initiation of treatment. For 23 patients in each group, skin samples were negative for fungi by day 18. Clinical improvement was slow; first scaling disappeared and then erythema and inflammation. Dyschromia persisted during the observation period. Six patients had adverse reactions to treatment; none discontinued treatment.

Adolescent↗
PubMedDate not supplied

Itraconazole in pityriasis versicolor: ultrastructural changes in Malassezia furfur produced during treatment.

Twenty-eight patients with pityriasis versicolor were treated orally with 200 mg of itraconazole per day in an open, randomized comparison of five-day and seven-day treatment regimens. The morphologic changes in Malassezia furfur produced by treatment were confirmed by studies with transmission and scanning electron microscopy. The clinical results showed that seven days of treatment were more effective than five days. Transmission electron microscopy revealed cytopathic changes in the fungus at the end of treatment, intracellular necrosis being complete within seven to 28 days. Cell-surface alterations detected by scanning electron microscopy developed more slowly--maximal changes were observed 14 days after the beginning of treatment. One patient developed nausea during treatment; no other adverse effects were attributed to the drug.

Administration, Oral↗
PubMed1986

Itraconazole, a new orally active antifungal, in the treatment of pityriasis versicolor.

Itraconazole, a new orally active triazole antifungal, has been tested in patients with pityriasis versicolor. A comparison of different dose schedules was carried out in 73 patients. A regime of 100 mg itraconazole daily for 15 days gave a 100% response rate; 200 mg daily for 5 days gave an 80% response rate. Two patients, who had received 50 mg itraconazole for 14 days, relapsed within 2 months of finishing treatment. Only two patients reported minor side-effects.

Administration, Oral↗
PubMed1986

Itraconazole therapy in pityriasis versicolor.

The efficacy of itraconazole was assessed in an open trial in 30 patients with disseminated lesions of pityriasis versicolor confirmed by direct microscopy. The patients were allocated randomly to one of two treatment regimens, 200 mg once daily for 5 days or 100 mg once daily for 10 days. On assessment 3 weeks after the end of the treatment, 25 patients were healed, two patients had mild residual lesions, two had considerable residual lesions and one patient had relapsed. One patient reported dyspepsia and one patient reported stomach ache. One patient had asymptomatic elevation of serum transaminase (GOT and GPT) but this had returned to normal 3 weeks after the end of therapy.

Adolescent↗
PubMed1990

Changes in fungal ultrastructure after short-course ciclopiroxolamine therapy in pityriasis versicolor.

The clinical outcome and the effects on morphogenesis and cell ultrastructure induced by a 1% ciclopiroxolamine solution in six patients with proven pityriasis versicolor were studied. Treatment regimens consisting of a once-daily application for 1 day, 2 days (Days 1 and 4) or 3 days (Days 1, 4 and 8). Clinical evaluation, scanning (SEM) and transmission electron microscopy (TEM) were performed on skin scrapings before treatment, and at 3, 7, 15 and 21 days after the start of therapy. SEM techniques have shown severe changes in the surface ultrastructure of yeasts and hyphae of Pityrosporum spp. (Malassezia furfur) 15 days after the start of therapy. TEM techniques showed extensive internal disruption, mainly severe necrosis of the cytoplasm, 3 and 7 days after the start of treatment. However, KOH direct microscopy showed apparently normal morphology of Pityrosporum spp. (Malassezia furfur) at all assessment points. The final clinical cure in all the patients was achieved 21 days after the start of therapy.

Antifungal Agents↗
PubMed1993

Langerhans cell accumulation in chronic tinea pedis and pityriasis versicolor.

Persistence of chronic tinea pedis (CTP) and pityriasis (tinea) versicolor (PIVE) has been tentatively attributed to an impaired cellular immune response. Therefore immunophenotyping of the inflammatory infiltrates in both disorders was performed in order to detect possible defects in cellular defence. The results of the present study show a dominance of memory T cells, an accumulation of macrophages and lack of B cells. A very prominent feature in CTP and especially PIVE was a marked accumulation of Langerhans cells (LCs) in the epidermis, mostly without expression of CD4. Furthermore, reduced expression of cellular activation markers and the presence of suppressor T cells was noted. In general, the cellular response in PIVE appeared to be slightly stronger than in CTP. This composition of the inflammatory infiltrates in chronic dermatomycoses is similar to previous findings in a variety of dermatoses. However, in PIVE and CTP local reduction of delayed-type hypersensitivity may occur. The function of LCs in these infections is therefore of special interest.

Chronic Disease↗
PubMed1987

Pityriasis versicolor and Pityrosporum ovale. Morphogenetic and ultrastructural considerations.

Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) have been performed on skin material of patients with pityriasis versicolor who were orally treated with itraconazole. Before as well as after therapy, variously sized spherical structures were observed on the surface of the keratinocytes with SEM. TEM examination revealed Pityrosporum ovale, predominantly in its mycelial phase, inside keratinocytes. The spherules as observed by SEM appeared to be amorphous, lipid-like droplets originating from the inside of the keratinocytes. The cytoplasm of the keratinocytes was at least partly occupied by the same amorphous material. It is therefore suggested that P. ovale penetrates the keratinocyte where degradation of the normal keratinous content to amorphous material takes place. This newly formed lipidic substrate may be an essential nutritive factor. The lipidified state of the stratum corneum persisted for at least 3 weeks after eradication of the fungus by itraconazole. It is speculated that the presence of large quantities of this lipid-like material might be the cause of hypopigmentation because it may constitute an ultraviolet light block.

Humans↗
PubMed1984

HLA antigens in pityriasis versicolor.

The distribution of 30 HLA antigens was studied in 48 patients with Pityriasis Versicolor and 134 controls. No significant deviations were found in the patient group after correction for the number of antigens tested.

Cytotoxicity, Immunologic↗
PubMedDate not supplied

Pityriasis versicolor of the face.

Pityriasis versicolor (p.v.) is a superficial mycosis occurring frequently on the face. Epidemiological and clinical data regarding cases of p.v. on the face over a period of 11 years are discussed and some explanation given for conditions which favour facial involvement. This study underlines that face lesions of p.v. are more common in children than in adults and in females than in males. The forehead is the site of facial involvement usually affected. Clinical features are variable but we often observed achromic or hypopigmented scaling lesions, smaller than trunk patches.

Adolescent↗
PubMedDate not supplied

Pityriasis versicolor in a newborn.

Pityriasis versicolor is a superficial mycosis that rarely afflicts children. We present a case in a 2-month-old male baby in good health, with hyper- and hypopigmented macules located in the cervical region and on the scalp, face and chest. Moreover, we report our record of cases in infancy and the predisposing factors.

Age Factors↗
PubMedDate not supplied

The epidemiology of pityriasis versicolor in Malawi, Africa.

During a total population survey in 1988 and 1989 in Karonga district, northern Malawi, 4915/61735 (8.0%) people examined were found to have extensive pityriasis versicolor (PV). An additional 6085 people (9.9%) were diagnosed as having mild disease. The highest prevalence rates of extensive and mild PV were found among subjects aged 15-24 years. In this age group between 20% and 25% of people had extensive PV. Rates were generally higher among males than among females. PV was rarely found in prepubertal subjects.

Adolescent↗