Pityriasis versicolor: an update on pharmacological treatment options.

INTRODUCTION: Pityriasis versicolor (PV) is a superficial fungal infection caused by Malassezia species; a yeast that naturally colonizes on the skins surface. High efficacy rates are generally obtained with both topical and systemic treatments. However, recurrence rates following successful treatment remain high and there are no dosage guidelines available for administration of systemic antifungal agents that carry risks of adverse events. AREAS COVERED: This review focused on providing an overview of existing treatments for PV and an introduction to new treatments. A literature search was conducted using the search strategy, pityriasis versicolor OR tinea versicolor. Over the past decade, few new treatments have been introduced, but the efficacy and the dosing regimens of existing treatments have been systematically reviewed. The results of these reviews are discussed. EXPERT OPINION: Existing topical and systemic agents are both effective treatments against PV. Previous dosage recommendations for systemic agents have been modified based on recent evidence elucidated in systematic reviews. However, the absence of standardized collection and reporting practices in clinical trials precludes any conclusions to be drawn regarding the efficacy and safety of topical and systemic agents in comparison or in concert with each other.

Novos aspectos na evolução clínica da pitiríase versicolor / New aspects in the clinical course of pityriasis versicolor

FUNDAMENTO: A pitiríase versicolor é uma doença infecciosa causada por várias espécies de Malassezia com uma tendência a se tornar recidivante ou crônica. OBJETIVOS: Este trabalho foi conduzido na tentativa de conhecer a evolução clínica da pitiríase versicolor em relação ao número de recidivas após um tratamento adequado no período de 12 meses e correlacionar o número de recidivas com as espécies de Malassezia isoladas. MATERIAL E MÉTODOS: Cento e dois pacientes com diagnóstico clínico e laboratorial de pitiríase versicolor foram acompanhados por um período de 12 meses para observarmos o número de recidivas da doença. RESULTADOS: A pitiríase versicolor, após um tratamento adequado, apresentou três tipos de evolução clínica num período de 12 meses: pitiríase versicolor sem nenhum episódio de recidiva (32,35 por cento); pitiríase versicolor recidivante, com um a quatro episódios de recidiva (52,94 por cento) devidos a fatores de predisposição relacionados; e pitiríase versicolor crônica, com mais de quatro episódios de recidiva (14,70 por cento) sem nenhuma relação com fatores de predisposição. CONCLUSÕES: A pitiríase versicolor apresentou uma evolução clínica de acordo com o número de episódios de recidiva da doença analisados durante um período de 12 meses que pode ser considerada da seguinte maneira: pitiríase versicolor com cura clínica e micológica, pitiríase versicolor recidivante e pitiríase versicolor crônica.

BACKGROUND: Pytiriasis versicolor is an infectious disease caused by several Malassezia species which has a tendency to become relapsing or chronic. OBJECTIVES: This study was conducted in an attempt to investigate the clinical course of pityriasis versicolor with regard to the number of relapses after a 12-month therapy and correlate this number with isolates of Malassezia species. MATERIAL AND METHODS: 102 patients with clinical and laboratory diagnosis of pityriasis versicolor were monitored for 12 months to investigate the number of relapsing episodes of the disease. RESULTS: After appropriate treatment, pityriasis versicolor presented three types of clinical course: pity - riasis versicolor without relapsing episodes (32.35 percent), relapsing pityriasis versicolor with one to four relapsing episodes (52.94 percent ) due to associated predisposing factors, and chronic pityriasis versicolor with more than four relapsig episodes (14.70 percent) with no relation to predisposing factors. CONCLUSIONS: The clinical course of pityriasis versicolor varied according to the number of relapsing episodes of the disease analyzed over a period of 12 months and can be classified as follows: pityriasis versiolor with clinical and mycological clearing, relapsing pityriasis versicolor and chronic pityriasis versicolor.

New aspects in the clinical course of pityriasis versicolor.

BACKGROUND: Pytiriasis versicolor is an infectious disease caused by several Malassezia species which has a tendency to become relapsing or chronic. OBJECTIVES: This study was conducted in an attempt to investigate the clinical course of pityriasis versicolor with regard to the number of relapses after a 12-month therapy and correlate this number with isolates of Malassezia species. MATERIAL AND METHODS: 102 patients with clinical and laboratory diagnosis of pityriasis versicolor were monitored for 12 months to investigate the number of relapsing episodes of the disease. RESULTS: After appropriate treatment, pityriasis versicolor presented three types of clinical course: pityriasis versicolor without relapsing episodes (32.35%), relapsing pityriasis versicolor with one to four relapsing episodes (52.94% ) due to associated predisposing factors, and chronic pityriasis versicolor with more than four relapsing episodes (14.70%) with no relation to predisposing factors. CONCLUSIONS: The clinical course of pityriasis versicolor varied according to the number of relapsing episodes of the disease analyzed over a period of 12 months and can be classified as follows: pityriasis versicolor with clinical and mycological clearing, relapsing pityriasis versicolor and chronic pityriasis versicolor.

Progressive macular hypomelanosis in a 16-year old.

Progressive macular hypomelanosis of the trunk is a disease of unclear etiology that often goes unrecognized in the clinical setting. We present a Caucasian adolescent girl with hypopigmented macules coalescing into patches on her trunk, initially diagnosed as tinea versicolor. Upon further evaluation, the patient was found to have progressive macular hypomelanosis that demonstrated improvement with sunlight exposure and doxycycline. We report this patient to make physicians more aware of this entity and discuss the literature.

Quantification of ultraviolet protective effects of pityriacitrin in humans.

Pityriacitrin (PIT), produced by Malassezia yeasts, is an UV absorbing substance that might cause hypopigmentation in pityriasis versicolor alba. We aimed to investigate the UV protective effect of PIT in humans using in vitro and in vivo test methods. Spectrophotometry of PIT cream and the vehicle was performed in the wavelength range from 290 to 400 nm. UV transmission and the sun protection factor (SPF) were assessed for different cream formulations. Using colorimetry we evaluated erythema and pigmentation following irradiation of cream-protected and non-protected skin of healthy subjects. UVB as well as UVA transmission decreased with increasing PIT concentrations. An increase of PIT concentration of 1.25, 2.5, and 5% was associated with slightly increasing SPFs of 1.4, 1.5, and 1.7, respectively. Our in vivo tests confirmed the validity of the SPF of PIT 5% cream determined in vitro. In conclusion, the UV protective effect of PIT is all in all very weak suggesting that PIT is likely only an inferior cofactor in the development of hypopigmentation in pityriasis versicolor alba lesions following sun exposure.

Pityriasis versicolor: a review of pharmacological treatment options.

Pityriasis versicolor is a common disorder of the skin, which is characterised by scaly hypo- or hyperpigmented lesions on the body. The lipophilic yeast, Malassezia, is considered to be the aetiological agent of this disease. A number of treatment options, both topical and systemic, have been shown to be effective. A critical evaluation of treatment options is presented.

Micosis superficiales: candidiasis y pitiriasis versicolor / Superficial mycosis: candidiasis and pityriasis versicolor

Se exponen las características clínicas de las lesiones cutáneas en las candidiasis y la pitiriasis versicolor. Se hace hincapié en las medidas de educación, prevención y control de estas afecciones a nivel primario de atención médica. Se exponen además las diferentes maniobras terapéuticas, tanto tópicas como sistémicas, con las que se cuenta para su tratamiento, y se hace referencia a las medidas terapéuticas alternativas que brinda la medicina natural y tradicional para estas afecciones(AU)

Micosis superficiales: candidiasis y pitiriasis versicolor / Superficial mycosis: candidiasis and pityriasis versicolor

Se exponen las características clínicas de las lesiones cutáneas en las candidiasis y la pitiriasis versicolor. Se hace hincapié en las medidas de educación, prevención y control de estas afecciones a nivel primario de atención médica. Se exponen además las diferentes maniobras terapéuticas, tanto tópicas como sistémicas, con las que se cuenta para su tratamiento, y se hace referencia a las medidas terapéuticas alternativas que brinda la medicina natural y tradicional para estas afecciones

[Evaluation of the fungicidal-fungistatic activity of various preparations for the cure and prevention of seborrheic dermatitis]. / Valutazione dell'attività fungistatica-fungicida di alcuni preparati per la cura e la prevenzione della dermatite seborroica.

Fungistatic and fungicide activity of 4 preparations available on the market for the prevention and treatment of infection due to P. ovale has been defined. P. ovale is a microorganism which complicates phlogosis of seborrhoeic dermatitis. The advantages of the presence of a limited antifungal activity are considered.

Pityrosporum orbiculare y pityrosporum ovale prevalencia en piel sana de niños y ancianos de comunidad educativa y asilo en el Estado Zulia / Pityrosporum orbiculare and pityrosporum ovale prevalence in skin health of children and ancients of comunity educational and asilum in the State Zulia

Con el fin de determinar la prevalencia de pityrosporum orbiculare y Pityrosporum ovale en piel sana de un grupo de niños (pre-escolares y escolares) de una Comunidad Educativa, y ancianos residenciados en una Casa Hogar (Asilo), se realizó el presente estudio. Para ello se tomaron muestras de diferentes áreas del cuerpo por el método de la cinta "Scocht Tape" (Transparente). Analizando los resultados obtenidos se confirma la presencia de ambas especies de Pityrosporum en un 79,50%, correspondiendo un 49,60% al grupo de niños y 29.90% al de ancianos, quedando demostrado estadísticamente que la presencia de Pityrosporum está asociada al período de vida. Relacionando la presencia de Pityrosporum con el sexo, se observó que en el grupo de ancianos un 37.50% correspondió al masculino y un 56.25% al femenino, siendo la diferencia en estos porcentajes estadísticamente significativas; resultados diferentes se obtuvieron en el grupo de niños, donde un 36.40% correspondió al sexo masculino y un 35.90% al femenino. En la población estudiada se observó el Pityrosporum orbiculare colonizando en forma individual en un 68.40% y colonizando asociado a Pityrosporum ovale en un 36.60%. Es de resaltar que el Pityrosporum ovale nunca se observó colonizando en forma individual. Debido al carácter lipofílico del Pityrosporum, fue notoria la variación en la distribución sobre piel sana, encontrándose la más alta prevalencia en aquellas áreas en las cuales la actividad excretora de las glándulas sebáceas es mayor, como son cara y cuero cabelludo. Los resultados de este estudio reafirman la afinidad del Pityrosporum orbiculare por los folículos pilosos, así como la presencia del Pityrosporum ovale en el cerumen el cual representa su gran reservorio

[Prevention of mycoses caused by yeasts]. / Verhütung von Mykosen durch Sprosspilze.

The wide-spread ubiquitous occurrence of molds and great masses of aerial spores (conidia, arthrospores etc.) as well as of yeast species with facultative pathogenicity, renders prophylaxis of respective human infections caused by such opportunists, rather difficult. Suppression of such fungi and continuous surveillance of endangered patients require considerable efforts and costs. Adequate control is particularly cumbersome in Candida infections, since the causative yeasts may be considered as "normal" commensals of the mucous membranes in many individuals. Overt secondary infections are frequently of endogenous origin, hence the name "endomycoses" as introduced by Gemeinhardt (1976). Under particular conditions such as care for patients with extended burns, or patients after bone-marrow transplantation or irradiation of the whole body, or patients after joint surgery, the complete elimination of yeasts is just as essential as the antibacterial decontamination over a limited period of time. In other groups of individuals similar drastic measures of control against Candida albicans are not deemed necessary. Reduction of local Candida cell counts to amounts below the individual level of tolerance may be deemed sufficient. Since the level of tolerance is, however, extremely low in infants and in many patients of the intensive care wards, especially in cases of malignant immunocytomas and leukemias of various nature, prophylaxis by proper hygienic measures and eventual preventive antimycotic treatment is an integral part of proper control.

Tinea versicolor: treatment and prophylaxis with monthly administration of ketoconazole.

Twenty-two patients with tinea versicolor (pityriasis versicolor) were treated with a single 400 mg dose of ketoconazole and evaluated one month later. All patients were found to be clinically cured when examined with Wood's light and microscopic techniques approximately one month after the initial dose. Hypopigmented macules persisted for several months in most patients. Prophylaxis with single monthly doses of 400 mg of ketoconazole has resulted in one recurrence to date, with follow-up for four to fifteen months (mean of 8.2 months) in twenty patients. No side effects from ketoconazole were reported by any of the patients.