Pityriasis versicolor in a newborn

Tinea Versicolor in a Three-Month Infant: A Case Report and Literature Review

Tinea versicolor (TV) is a superficial fungal disease caused by Malassezia furfur, most commonly affecting adolescents and adults. TV is uncommon among newborns, particularly those aged under one year. Poor hygiene and perspiration, immunosuppression, the use of oils and greasy lotions, hyperhidrosis, and corticosteroids may all contribute to the appearance of the condition. It is clinically distinguished by hypopigmentation or hyperpigmentation. Most often, it occurs over the trunk. Treatment for TV usually begins with the use of a topical antifungal. This case report presents a rare TV in a three-month-old boy who exhibited multiple hypopigmented macules on his trunk without pruritus. Examination of the wood lamp showed bright yellow fluorescent lesions. The potassium hydroxide (KOH) preparation revealed yeast and short mycelial forms, confirming the diagnosis of TV. The baby was given a clotrimazole solution for topical use twice a day. KOH preparation was negative, and the lesions had improved at the time of the two-month follow-up. This case highlights the importance of considering TV as a potential diagnosis in infants with atypical skin manifestations, although it is more commonly seen in older individuals.

Tinea versicolor in a premature infant

Tinea versicolor (TV) is a fungal skin infection that classically affects adolescents and young adults. Occasionally, it may be seen on the face of infants. We report an unusual case of widespread cutaneous TV in a premature infant.

Infantile hypopigmented pityriasis versicolor: two uncommon cases

Pityriasis versicolor is a common infection of the epidermis in adults, but only a few cases of this infection (especially the hypopigmented type) have been reported in infants aged under one year. Herein, we document a report of these cases and a review of the literature. Two patients with infantile pityriasis versicolor, who presented with hypopigmented macules on the neck, upper back, and chest are reported. A KOH examination was suggestive of pityriasis versicolor and our patients responded well to 1% clotrimazole lotion (twice a day) for four weeks. Pityriasis versicolor should be considered in the differential diagnosis of hypopigmented macules and patches in infants.

Prevalence of Ectoparasitic Infections and Other Dermatological Infections and Their Associated Factors among School Children in Gampaha District, Sri Lanka

Skin disorders are one of the commonest conditions among school children in developing countries. There are only a few published studies available from Sri Lanka on the prevalence of skin disorders. A community-based cross-sectional study was carried out among five government-run schools randomly selected from the district of Gampaha, Sri Lanka, during 2016-2017. A total of 41 students between 5 and 16 years of age were randomly selected from each school. Sociodemographic profile and hygienic behaviors of selected students were assessed using a pretested interviewer-administered questionnaire. Students were examined by a medical officer for the presence of different skin disorders. The chi-squared test of association and binary logistic regression were used for the identification of the significance of socioeconomic factors and hygienic practices among the study participants. A total of 205 school children participated in the study. The commonest skin disorder was pediculosis (42.0%; n=86), followed by dandruff (8.3%; n=17), fungal infections (6.8%; n=14), and scabies (1.5%; n=3). Almost one-fourth of the study participants (22.9%; n=30/131) had more than one disorder, majored by Pediculus captis infestation with dandruff. Over one-third (36.1%; n=74) were free of any skin disorders. The prevalence of skin disorders was significantly high among females (87.3%; n=110), compared to males (26.6%; n=21). Presence of long hair, higher family size, and limited number of rooms in the house were risk factors associated with the prevalence of skin disorders. The commonest skin disorder was pediculosis, while scabies and fungal infections were scarce among school children in the district of Gampaha, Sri Lanka. Implementation of health education and monitoring programs at the school level for maintaining the dermal health status of school children is recommended.

[Pityriasis versicolor in infants: unusual clinical presentation and role of corticosteroids used as depigmenting agent for cosmetic purposes in the mother]

We report two cases of Pityriasis versicolor (PV) in infants aged 12 and 18 months. The latter were brought to medical attention because of hypochromic and achromic, round macules involving the limbs and the face. Physical examination of their mothers showed voluntary depigmentation for cosmetic purposes due to the use of corticosteroids and hydroquinone, on average, over a 5-year period. The scotch tape test performed in one of the infants and his mother showed short filaments and clusters of spores. Treatment was based on ketoconazole. After 8 weeks, all patients reported favorable outcomes despite the persistence of some hypochomic macules. The peculiarities of this study are, on the one hand the topography of the lower limbs and on the other hand a positive family history of PV whose occurrence is favored by the use of depigmenting agents based on corticosteroids. Corticosteroids favor the atrophic and achromic feature of the lesions. Indeed, achromic lesions on the lower limbs were described in adults undergoing artificial depigmentation.

Naftifine hydrochloride (NH) in the treatment of pityriasis versicolor

Introduction & objectives: The purpose of this study was to demonstrate the efficacy comparability of 1% NH lotion vs. of 1% NH cream (exoderil, Sandoz) in the treatment of pityriasis versicolor. Material & methods. 71 patients with pityriasis versicolor were randomly allocated either to receive NH lotion once daily (NH lotion group (п = 35, 38.6 years (95% CI [33,7, 43.5]) or NH cream once daily (NH cream group (п = 36, 40.8 years (95% CI [36,6, 45.0]) for 14 days. Mycological evaluations (microscopy and culture) were performed at weeks 2 and 3, inflammation symptoms evaluations were scored at day 3, weeks 2 and 3 after start of the therapy. Overall cure rates assessment included results of mycological, clinical outcomes and safety evaluation. Results. There was no difference between groups in mycological cure rates (94% vs 92%) and inflammation regression (97% vs 97%). Overall cure rate was 91% and 92% of patients in NH lotion and NH cream groups respectively (p = 0,97). Conclusion. 1% NH lotion and 1% NH cream are effective in the treatment of pityriasis versicolor.

Influence of systemic corticotherapy on the triggering of pityriasis versicolor

Pityriasis versicolor is a frequent mycosis and the use of systemic corticotherapy is one of its predisposing factors. This is an observational, cross-sectional, analytical and comparative study, conducted from January 2012 to January 2013 in the following outpatient clinics: Dermatology Service, Cassiano Antonio Moraes Hospital (HUCAM), Vitória, ES, Brazil; Nephrology Service, HUCAM; and Leprosy Department, Maruípe Health Unit, Vitória, ES, Brazil. Patients, undergoing long-term systemic corticotherapy (or not), were assessed with respect to the presence of pityriasis versicolor. If there was mycosis, a direct mycological examination would be carried out. The spss 17.0 software was used for the statistical analysis. From the total of 100 patients, nine had pityriasis versicolor, being eight from the corticotherapy group and one from the group with no use of corticosteroids. Regarding the patients with mycosis, the prevalent age ranged from 20 to 39 years, with six patients; six were women; seven mixed race; eight were undergoing long-term systemic corticotherapy; seven were taking low-dose systemic corticosteroids; four had leucocytosis; five had normal total cholesterol and triglycerides; and four had normal glycaemia. There was increased frequency of pityriasis versicolor in the group undergoing systemic corticotherapy with statistical significance, corroborating the only study on the topic (1962).

The Malassezia genus in skin and systemic diseases

In the last 15 years, the genus Malassezia has been a topic of intense basic research on taxonomy, physiology, biochemistry, ecology, immunology, and metabolomics. Currently, the genus encompasses 14 species. The 1996 revision of the genus resulted in seven accepted taxa: M. furfur, M. pachydermatis, M. sympodialis, M. globosa, M. obtusa, M. restricta, and M. slooffiae. In the last decade, seven new taxa isolated from healthy and lesional human and animal skin have been accepted: M. dermatis, M. japonica, M. yamatoensis, M. nana, M. caprae, M. equina, and M. cuniculi. However, forthcoming multidisciplinary research is expected to show the etiopathological relationships between these new species and skin diseases. Hitherto, basic and clinical research has established etiological links between Malassezia yeasts, pityriasis versicolor, and sepsis of neonates and immunocompromised individuals. Their role in aggravating seborrheic dermatitis, dandruff, folliculitis, and onychomycosis, though often supported by histopathological evidence and favorable antifungal therapeutic outcomes, remains under investigation. A close association between skin and Malassezia IgE binding allergens in atopic eczema has been shown, while laboratory data support a role in psoriasis exacerbations. Finally, metabolomic research resulted in the proposal of a hypothesis on the contribution of Malassezia-synthesized aryl hydrocarbon receptor (AhR) ligands to basal cell carcinoma through UV radiation-induced carcinogenesis.

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.