RESUMO
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.
Assuntos
Caspa , Malassezia , Pitiríase , Dermatoses do Couro Cabeludo , Epiderme , Humanos , Pitiríase/tratamento farmacológico , Pitiríase/etiologiaAssuntos
Pitiríase/etiologia , Pitiríase/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Pitiríase/terapiaRESUMO
Pityriasis amiantacea (PA) is a hair disorder characterized by matting of multiple hair shafts, typically occurring as an idiopathic condition. A 67-year-old woman with multiple myeloma who developed PA following a bone marrow transplant with melphalan conditioning is described.She noted initial changes in scalp hair regrowth 4 weeks posttransplant. During the next 4 months she developed multiple lesions of PA that rapidly responded to management, including mineral oil under occlusion in the evening followed by daily shampooing with alternating coal tar, salicylic acid, and ketoconazole shampoos. We review medications that have been associated with PA and conditions related to PA, including atopic dermatitis, bacterial infection, fungal infection, psoriasis, and seborrheic dermatitis. Our patient developed PA that was associated with either melphalan conditioning, bone marrow transplant, or both.
Assuntos
Transplante de Medula Óssea/efeitos adversos , Doenças do Cabelo/terapia , Mieloma Múltiplo/terapia , Pitiríase/terapia , Idoso , Feminino , Doenças do Cabelo/etiologia , Humanos , Pitiríase/etiologiaAssuntos
Antineoplásicos/uso terapêutico , Leucemia Mieloide Aguda/complicações , Pitiríase/diagnóstico , Sangue Fetal/transplante , Proteínas Filagrinas , Humanos , Proteínas de Filamentos Intermediários/análise , Leucemia Mieloide Aguda/terapia , Masculino , Pessoa de Meia-Idade , Pitiríase/etiologia , Pitiríase/patologia , Pitiríase/terapia , Indução de Remissão/métodos , Pele/patologia , Resultado do TratamentoRESUMO
Pityriasis amiantacea (PA) is a papulosquamous condition of the scalp,characterized by asbestos - like thick scales attached to the hair shaft. It is thought to represent a reaction pattern to inflammatory skin disorders like psoriasis, seborrhoeic dermatitis, tinea capitis, atopic dermatitis and lichen planus, rather than a distinctive disease. The scaling may be localised or generalised, depending on the underlying condition and its duration.This report highlights the clinical features of pityriasis amiantacea secondary to atopic dermatitis and the differential features of other papulo-squamous scalp disorders such as scalp psoriasis, seborrhoeic dermatitis and lichen planus.Scalp psoriasis and seborrhoeic dermatitis are the commonest causes of PA as well as the closest differentials hence should be excluded in all cases. The longterm sequelae of PA include scalp fibrosis and permanent hair loss hence should be identified and treated promptly. The management modalities of PA will also be discussed.
Assuntos
Pitiríase/diagnóstico , Pitiríase/terapia , Dermatoses do Couro Cabeludo/etiologia , Adolescente , Feminino , Humanos , Pitiríase/etiologia , Dermatoses do Couro Cabeludo/diagnóstico , Dermatoses do Couro Cabeludo/terapiaRESUMO
Pityriasis rotunda (PR) is an uncommon chronic dermatosis, which may be idiopathic or may be associated with infections or malignancy. We describe the clinical and biochemical findings of two patients with multiple myeloma, who were incidentally diagnosed with PR, and detail the clinical conditions with which this rare paraneoplastic phenomenon may be associated. Although PR is a rare condition, it may be found as a paraneoplastic phenomenon in a range of conditions, and thus should be recognised as an important clinical sign.
Assuntos
Mieloma Múltiplo/complicações , Síndromes Paraneoplásicas/patologia , Pitiríase/patologia , Idoso , Feminino , Humanos , Achados Incidentais , Pessoa de Meia-Idade , Pitiríase/etiologiaRESUMO
We present a 65-year-old man with Darier disease with pityriasis amiantacea on the scalp, alopecia, and congenital facial nerve palsy.
Assuntos
Alopecia/etiologia , Doença de Darier/complicações , Doenças do Nervo Facial/congênito , Pitiríase/etiologia , Acantólise/etiologia , Idoso , Alopecia/patologia , Doença de Darier/tratamento farmacológico , Doença de Darier/genética , Doença de Darier/patologia , Doenças do Nervo Facial/complicações , Humanos , Isotretinoína/uso terapêutico , Masculino , Pitiríase/patologia , ATPases Transportadoras de Cálcio do Retículo Sarcoplasmático/genética , Couro Cabeludo/patologiaRESUMO
Pityriasis alba (PA) is a localized hypopigmented disorder of childhood with many existing clinical variants. It is more often detected in individuals with a darker complexion but may occur in individuals of all skin types. Atopy, xerosis, and mineral deficiencies are potential risk factors. Sun exposure exacerbates the contrast between normal and lesional skin, making lesions more visible and patients more likely to seek medical attention. Poor cutaneous hydration appears to be a common theme for most risk factors and may help elucidate the pathogenesis of this disorder. The end result of this mechanism is inappropriate melanosis manifesting as hypopigmentation. It must be differentiated from other disorders of hypopigmentation, such as pityriasis versicolor alba, vitiligo, nevus depigmentosus, and nevus anemicus. Alleviation of the various risk factors via patient education on proper skin care and hygiene, use of lubricants and emollients, topical corticosteroid therapy in the presence of inflammation, and the novel administration of topical anti-inflammatory drugs such as calcineurin inhibitors can play a crucial role in promoting remission or resolution.
Assuntos
Hipopigmentação/diagnóstico , Pitiríase/diagnóstico , Adolescente , Corticosteroides/uso terapêutico , Inibidores de Calcineurina , Criança , Pré-Escolar , Diagnóstico Diferencial , Emolientes/uso terapêutico , Feminino , Humanos , Hipopigmentação/epidemiologia , Hipopigmentação/etiologia , Hipopigmentação/terapia , Lubrificantes/uso terapêutico , Masculino , Pitiríase/epidemiologia , Pitiríase/etiologia , Pitiríase/terapia , Prognóstico , Terapia UltravioletaAssuntos
Doença de Darier/complicações , Pitiríase/etiologia , Dermatoses do Couro Cabeludo/etiologia , Administração Tópica , Criança , Doença de Darier/tratamento farmacológico , Doença de Darier/patologia , Fármacos Dermatológicos/uso terapêutico , Feminino , Humanos , Isotretinoína/uso terapêutico , Pitiríase/tratamento farmacológico , Pitiríase/patologia , Dermatoses do Couro Cabeludo/tratamento farmacológico , Dermatoses do Couro Cabeludo/patologia , Resultado do TratamentoRESUMO
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.
Assuntos
Face/parasitologia , Infestações por Ácaros/etiologia , Ácaros , Fotoquimioterapia/efeitos adversos , Fototerapia/efeitos adversos , Dermatopatias Parasitárias/etiologia , Adolescente , Adulto , Animais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infestações por Ácaros/parasitologia , Pitiríase/etiologia , Pitiríase/parasitologia , Psoríase/terapia , Doses de Radiação , Rosácea/etiologia , Rosácea/parasitologia , Dermatopatias Parasitárias/parasitologia , Estatísticas não Paramétricas , Vitiligo/terapiaRESUMO
Hypomelanotic skin disorders are cutaneous pigmentary disorders characterized by a reduced melanin content in the skin that results in a lightening of the skin. Establishing the correct diagnosis for hypomelanotic skin disorders requires a good history, a detailed physical examination, the use of special lighting techniques, such as Wood's light, and sometimes a biopsy of the abnormally pigmented skin and the normally pigmented skin. This article focuses on the origin, clinical presentation, and diagnosis of acquired hypomelanotic skin disorders. An algorithm for the diagnostic approach to these hypomelanoses is given.
Assuntos
Hipopigmentação/etiologia , Algoritmos , Humanos , Hipopigmentação/classificação , Hipopigmentação/diagnóstico , Líquen Escleroso e Atrófico/diagnóstico , Líquen Escleroso e Atrófico/etiologia , Melanoma/diagnóstico , Melanoma/etiologia , Nevo Pigmentado/diagnóstico , Nevo Pigmentado/etiologia , Pitiríase/diagnóstico , Pitiríase/etiologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/etiologia , Tinha Versicolor/diagnóstico , Tinha Versicolor/etiologia , Vitiligo/diagnóstico , Vitiligo/etiologiaRESUMO
OBJECTIVE: To determine the prevalence and severity of seborrheic dermatitis and pityriasis capitis in Australian preschool-aged children. DESIGN: A stratified cross-sectional skin survey using cluster sampling of centers throughout Victoria, Australia. SETTING: The study population included children attending child care centers, preschools, and Maternal and Child Health Centers, with the reference population being Australian children 5 years and younger. PARTICIPANTS: Of the 1,634 children in the original sample, 1.116 children aged 11 days to 5 years 11 months were included in the study. INTERVENTION: Parents completed a questionnaire recording demographic information and personal and family history of skin problems and related diseases. A dermatologist performed a total skin examination, including the diaper area for children younger than 12 months. MAIN OUTCOME MEASURE: The age- and sex-specific prevalence rates and site and severity of seborrheic dermatitis and pityriasis capitis were measured. RESULTS: The overall age- and sex-adjusted prevalence of seborrheic dermatitis was 10.0% (95% confidence interval [CI], 8.2%-11.7%): 10.4% (95% CI, 7.8%-12.9%) in boys and 9.5% (95% CI, 7.0%-12.0%) in girls. This was highest in the first 3 months of life, decreasing rapidly by the age of 1 year, after which it slowly decreased over the next 4 years. Most (71.9%) had disease classified as minimal to mild. Pityriasis capitis occurred in 41.7% (95% CI, 38.8%-44.6%) of the 1,116 children examined, with 85.8% categorized as minimal to mild only. CONCLUSIONS: Seborrheic dermatitis and pityriasis capitis are common in early childhood. Most children have minimal to mild disease that would require little if any treatment. Education programs directed at those caring for preschool-aged children are needed to provide information on simple preventative measures and treatment, if necessary, that could easily reduce the morbidity associated with these very common conditions.
Assuntos
Dermatite Seborreica/epidemiologia , Pitiríase/epidemiologia , Distribuição por Idade , Pré-Escolar , Estudos Transversais , Dermatite Seborreica/etiologia , Dermatite Seborreica/patologia , Dermatite das Fraldas/epidemiologia , Dermatite das Fraldas/etiologia , Dermatite das Fraldas/patologia , Extremidades , Dermatoses Faciais/epidemiologia , Dermatoses Faciais/etiologia , Dermatoses Faciais/patologia , Feminino , Educação em Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Pitiríase/etiologia , Pitiríase/patologia , Prevalência , Dermatoses do Couro Cabeludo/epidemiologia , Dermatoses do Couro Cabeludo/etiologia , Dermatoses do Couro Cabeludo/patologia , Índice de Gravidade de Doença , Inquéritos e Questionários , Vitória/epidemiologiaRESUMO
Malassezia furfur (Pityrosporum orbiculare) é um fungo lipofílico, que está associado a pitiríase versicolor, foliculite, dermatite seborréica e atópica, fungemia e infecções sistêmicas. O tratamento é feito com soluções antimicóticas ou derivados imidazólicos, particularmente, o cetoconazol. Dentro das perspectivas de avaliação de novas alternativas para a terapêutica das infecções micóticas, determinou-se, nesse estudo, a atividade antifúngica de compostos imídicos. As imidas 3,4-dicloro-N-fenil-maleimida (6,3 µg/ml), 3,4-dicloro-N-benzil-maleimida (25 µg/ml) e 3,4-dicloro-N-fenil-propil-maleimida (20 µg/ml) foram os compostos que apresentaram melhor atividade inibitória contra as cepas de M. furfur...
Assuntos
Antifúngicos/administração & dosagem , Imidas , Malassezia , Micoses , Pitiríase/etiologia , Pitiríase/terapia , Bioensaio , Meios de CulturaRESUMO
BACKGROUND: The aetiology of pityriasis alba (PA), a common dermatosis in childhood, is still controversial. The objective of this study was to assess the possible aetiopathogenic factors of this disease in infants. METHODS: Forty-four patients with PA and 31 healthy children were examined and compared. Personal hygiene habits, sun exposure, presence of Staphylococcus aureus in nasal fossae and presence of major or minor signs of atopy were assessed during anamnesis and physical examination. Susceptibility to ultraviolet (UV) B radiation was measured by the onset of a contact hypersensitivity reaction to diphenylcyclopropenone in individuals sensitized in previously irradiated areas. RESULTS: The prevalence of PA was higher in individuals with darker skin, in high phototype categories, as well as in males. The number of daily baths and sun exposure between 10.00 h and 15.00 h were significantly higher in the PA group when compared with controls (P = 0.03 and P = 0.0015, respectively). The presence of atopy signs was more common in pityriasis patients (P = 0.002). Susceptibility to UVB radiation was 29.6% in the PA group vs. 29.0% in the control group; nevertheless, important differences were found after stratification in order to control possible confounding factors. The presence of S. aureus in the nostrils was equal in both groups. CONCLUSIONS: Our results confirm that PA, in our population, is more prevalent in males and in individuals in higher phototype categories. In those with inadequate personal hygiene and sun exposure habits the disease is more accentuated, demonstrating that the xerosis presenting in individuals with atopic diathesis is an important element in the development of the disease. S. aureus is not an important aetiopathogenic factor in PA. Susceptibility to UVB becomes important when related to the patient's phototype.