Search

The use of personal protective equipment such as gloves and masks and protective measures such as repeated contact of hands with water and skin disinfectants are recommended to prevent the spread of Corona virus disease 2019 (COVID-19). However, these hygiene measures may cause skin injury and skin diseases, including superficial-cutaneous-fungal infections (SCFIs). The aim of this study was to determine the prevalence and comparison of SCFIs before and during the COVID-19 pandemic. In this retrospective cross-sectional study, the data of patients suspected of SCFIs who had been referred to two clinical mycology laboratories in Shiraz, Iran, before and during the COVID-19 pandemic were reviewed. Collected data included date of admission, demographic information, site of infection, risk factors associated with SCFIs, and results of diagnostic tests. A total of 3781 patients suspected of having SCFIs were included in the study. Among them, 1750 (46.28%) patients were positive for SCFIs, 778 (44.45%), and 972 (55.54%) belonged to the periods before and during the COVID-19 pandemic, respectively. The highest frequency of SCFIs before and during the pandemic was observed in the age group of 21–50 years (n = 910, 52%). Dermatophytosis was the most common SCFI before and during the COVID-19 pandemic. The highest and lowest infection sites before and during the pandemic were the fingernails (n = 496, 28.34%) and the auricle (n = 3, 0.17%), respectively. Our findings showed that the prevalence of SCFIs has increased during the COVID-19 pandemic. Knowing the pattern of SCFIs might help dermatologists with initial and experimental antifungal therapy for future pandemic diseases. [ABSTRACT FROM AUTHOR]

Copyright of Microbes & Infectious Diseases is the property of Microbes & Infectious Diseases and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Tinea versicolor is a common cutaneous fungal infection of the skin caused by a part of the resident flora of skin known as Malassezia species. This infection is recognized by pigmentation disturbance in the form of lesions and superficial scaling in the skin. Materials and Methods: This study was conducted on 350 students between the ages of 18-25 years who lived in a school dormitory and were suspected of clinical diagnosis of Tinea versicolor. The Scotch tape method was used to take samples from the infected skin of students, and methylene blue staining was used to prepare smears. Results: After mycological examinations, among the 350 suspected students, 30 cases tested positive for Tinea versicolor, including 17 males and 13 females. 43.3% (n: 13) of patients had hypopigmentation followed by hyperpigmentation (33.3%, n:10) and erythematous (23.3%, n:7). Conclusion: This study demonstrated a significant prevalence of Tinea versicolor among the students located in the dormitories, with a higher rate among male students. Different infection periods and lesions were observed in the cases, but no severe lesion was seen. [ABSTRACT FROM AUTHOR]

Background: Pityriasis versicolor (PV), a cutaneous fungal infection, most commonly affects adolescents and young adults and is associated with hyperhidrosis and humid weather. Understanding other factors associated with PV might help improve diagnostic and treatment practices. Objectives: PV's associations with patient demographics, comorbidities and medication exposures were assessed using the All of Us Database, a large, diverse, national database from the United States. Methods: A case–control study with multivariable analysis was performed. Results: We identified 456 PV case‐patients and 1368 control‐patients. PV case‐patients (vs. control‐patients) were younger (median age [years] (standard deviation): 48.7 (15.4) vs. 61.9 (15.5); OR: 0.95, CI: 0.94–0.96) and more likely to be men versus women (42.8% vs. 33.9%, OR: 1.45, CI: 1.16–1.79) and Black (19.5% vs. 15.8%, OR: 1.35, 95% CI: 1.02–1.80) or Asian (4.6% vs. 2.7%, OR: 1.86, CI: 1.07–3.24) versus White. PV case‐patients more frequently had acne (5.3% vs. ≤1.5%, OR: 5.37, CI: 2.76–10.48) and less frequently had type 2 diabetes mellitus (T2DM) (14.7% vs. 24.7%, OR: 0.52, CI: 0.39–0.70) and hypothyroidism (OR: 10.3% vs. 16.4%, OR: 0.59, CI: 0.42–0.82). In multivariable analysis, PV odds were significantly higher in those with acne and lower in those with T2DM, older age and female sex. Conclusions: Our results may be used as a basis for future studies evaluating whether acne treatment may decrease PV risk. Physicians could educate patients with acne about PV, including strategies to control modifiable PV risk factors, such as avoidance of hot and humid environments and avoidance of use of topical skin oils. [ABSTRACT FROM AUTHOR]

Abstract Background Tinea versicolor is a very common condition. We reported a specific follicular manifestation and proposed that this particular presentation might be related to the patient’s history of previous keratosis pilaris. Case presentation A 46-year-old Asian woman of Han ethnicity presented to the clinic with trunk lesions for over a year. On physical examination: multiple light brown patches of varying size centered on hair follicles in the axillae and trunk, with the patches on the back fusing together and scales visible on the surface of the patches. Finally, through fungal microscopy and pathological examination, the patient was diagnosed with folliculocentric tinea versicolor. Conclusions Follicular tinea versicolor is a rare type of tinea versicolor. It is still not clear what causes tinea versicolor to become folliculocentric. This case may suggest that patients with a history of keratosis pilaris may have a tendency to develop follicular centration in the course of other diseases.

Background: Tinea versicolor is a very common condition. We reported a specific follicular manifestation and proposed that this particular presentation might be related to the patient's history of previous keratosis pilaris. Case presentation: A 46-year-old Asian woman of Han ethnicity presented to the clinic with trunk lesions for over a year. On physical examination: multiple light brown patches of varying size centered on hair follicles in the axillae and trunk, with the patches on the back fusing together and scales visible on the surface of the patches. Finally, through fungal microscopy and pathological examination, the patient was diagnosed with folliculocentric tinea versicolor. Conclusions: Follicular tinea versicolor is a rare type of tinea versicolor. It is still not clear what causes tinea versicolor to become folliculocentric. This case may suggest that patients with a history of keratosis pilaris may have a tendency to develop follicular centration in the course of other diseases. [ABSTRACT FROM AUTHOR]

Pityriasis versicolor, a common skin fungal infection, is typically observed on trunk and limb skin. Here, we highlight an unusual presentation: scalp involvement, often overlooked due to its asymptomatic, mildly scaly patches. We report four pediatric cases, emphasizing the potential underestimation of this scalp variant. This case series underscores the importance of considering this diagnosis in patients with unexplained scalp hypopigmentation, especially in males with short hair who may readily notice these subtle changes. The report contributes to the understanding of this variant's clinical presentation and emphasizes the need for awareness among clinicians to ensure accurate diagnosis and appropriate management.

This narrative review presents a comprehensive overview of the diagnosis and management of pityriasis versicolor (PV), a common superficial fungal infection caused by the yeast Malassezia. PV is characterised by scaly hypopigmented or hyperpigmented patches, primarily affecting the upper trunk, neck, and upper arms. Regarding commensal interactions, Malassezia utilises nutrient sources without affecting the human host. In cases of pathogenicity, Malassezia can directly harm the host via virulence factors or toxins, or indirectly by triggering damaging host responses. The diagnosis typically relies on recognising characteristic clinical features. Due to the wide variability in its clinical presentation, recognising the differential diagnosis is critical. In this paper, we discuss the clinical differentials, with their dermatoscopic presentation, but also describe a range of helpful diagnostic techniques (microscopy, conventional and ultraviolet-induced fluorescence dermatoscopy, and confocal microscopy). Topical therapies are the primary treatment for PV, encompassing non-specific antifungal agents like sulphur with salicylic acid, selenium sulphide 2.5%, and zinc pyrithione. Additionally, specific topical antifungal medications with either fungicidal or fungistatic properties may also be incorporated into the topical treatment regimen, such as imidazoles, allylamines, and ciclopirox olamine. Systemic therapies might occasionally be used. Patient education and the promotion of good personal hygiene are pivotal to reduce the risk of recurrence. In recurrent cases, particularly during warmer and more humid periods, prolonged prophylaxis with topical agents should be considered. [ABSTRACT FROM AUTHOR]

Objective: We conducted a systematic review of the literature from the PubMed database from January 1, 2010, to December 31, 2021. The search criteria were “(pityriasis versicolor OR tinea versicolor) AND treatment,” with the full text available and the English language required. This review focuses on the clinical evidence supporting the efficacy of antifungal and non-antifungal treatment for pityriasis versicolor. Background: Pityriasis versicolor is a chronic superficial mycosis caused by the Malassezia species. The condition is one of the most common infections worldwide, particularly in tropical climates. Although it is a superficial infection, recurrences are high due to the presence of Malassezia in the normal skin flora. Summary: Topical and oral antifungal treatments effectively reduce the recurrence, leading to a lasting clinical and mycological cure. In addition to antifungal therapies, non-antifungal treatments have shown efficacy in cases of recurrent pityriasis versicolor and could be used as maintenance or preventive therapy. Due to high recurrence rates, prophylactic treatment may be necessary. [ABSTRACT FROM AUTHOR]

Background: The genus Malassezia is a normal flora of our body. It needs lipid supplements for its growth and is seen in the area rich in sebaceous glands. It is a causative agent of Pityriasis versicolor (PV), Malassezia folliculitis, seborrheic dermatitis and also associated with some systemic infection like fungemia, catheter acquired sepsis in patients receiving lipid parenteral nutrition. Increased incidence of Malassezia infection emphasizes the need of susceptibility to choose a specific and accurate treatment. The aim of this study was to evaluate the in-vitro activity of amphotericin B, fluconazole, ketoconazole and voriconazole against the Malassezia spp isolated from PV and healthy individuals. Methodology: Modification of the CLSI M27-A3 document method using Christensen's urea broth with the addition of 0.5% Tween 40 and 0.1% Tween 80 was performed to evaluate the optimal antifungal susceptibility patterns of the isolates. Results: The Malassezia spp from healthy and PV patients shows variability in susceptibility pattern. Among the different species the lowest Microbial Inhibition Concentration (MICs) were found in amphotericin B, ketoconazole and Fluconazole with MIC50 values of 0.62, 0.03 and 0.125 in healthy individuals respectively. Isolates from PV patients showed slight highest value of MIC50 0.5, 0.25 and 0.5 respectively. Conclusion: The susceptibility pattern showed intra species variation and difference between healthy and PV patients as well. This emphasizes the need to identify the species and to evaluate the antifungal susceptibility of Malassezia. Further investigation is needed to correlate the in-vitro activity of antifungal agents with clinical outcomes. [ABSTRACT FROM AUTHOR]

Background and Purpose: Species identification of Malassezia using culture-dependent methods is time-consuming due to their fastidious growth requirements. This study aimed to evaluate a rapid and accurate molecular method in order to diagnose the pityriasis versicolor (PV) and identify Malassezia species from direct clinical samples.Materils and Methods: Skin scraping or tape samples from patients with PV and healthy volunteers as the control group were collected. Diagnosis of PV was confirmed by direct microscopic examination. The DNA extraction was performed according to the steel bullet beating method. Polymerase chain reaction-restriction fragment length polymorphism assay using HhaI restriction enzyme was applied for the identification and differentiation of Malassezia species.Results: The PCR method was able to detect Malassezia in 92.1% of specimens which were also confirmed with microscopic examination. Statistically, a significant association was observed between the results of the two assays (P ˂ 0.001). Moderate agreement was identified between the two methods to diagnose the PV in both populations (Kappa: 0.55). Considering microscopic examination as the gold standard method for confirmation of PV, the sensitivity, specificity, positive predictive value, and negative predictive value values of the PCR assay for recognition of PV were 85%, 75%, 92%, and 60%, respectively. M. globosa and M. restricta were the most prevalent species isolated from patients.Conclusion: In this study, the two-step molecular method based on the amplification of the D1/D2 domain and digestion of the PCR product by one restriction enzyme was able to diagnose and identify Malassezia directly from clinical samples. Consequently, it can be said that the molecular-based method provides more facilities to identify fastidious species, such as M. restricta.

This narrative review presents a comprehensive overview of the diagnosis and management of pityriasis versicolor (PV), a common superficial fungal infection caused by the yeast Malassezia. PV is characterised by scaly hypopigmented or hyperpigmented patches, primarily affecting the upper trunk, neck, and upper arms. Regarding commensal interactions, Malassezia utilises nutrient sources without affecting the human host. In cases of pathogenicity, Malassezia can directly harm the host via virulence factors or toxins, or indirectly by triggering damaging host responses. The diagnosis typically relies on recognising characteristic clinical features. Due to the wide variability in its clinical presentation, recognising the differential diagnosis is critical. In this paper, we discuss the clinical differentials, with their dermatoscopic presentation, but also describe a range of helpful diagnostic techniques (microscopy, conventional and ultraviolet-induced fluorescence dermatoscopy, and confocal microscopy). Topical therapies are the primary treatment for PV, encompassing non-specific antifungal agents like sulphur with salicylic acid, selenium sulphide 2.5%, and zinc pyrithione. Additionally, specific topical antifungal medications with either fungicidal or fungistatic properties may also be incorporated into the topical treatment regimen, such as imidazoles, allylamines, and ciclopirox olamine. Systemic therapies might occasionally be used. Patient education and the promotion of good personal hygiene are pivotal to reduce the risk of recurrence. In recurrent cases, particularly during warmer and more humid periods, prolonged prophylaxis with topical agents should be considered.

Although the fungal microbiome in human skin mainly comprises lipophilic yeasts, including Malassezia species, these microorganisms can cause various dermatitis conditions, including pityriasis versicolor, seborrheic dermatitis, folliculitis, and atopic dermatitis, depending on the host condition. Both Malassezia globosa and Malassezia restricta are major species implicated in Malassezia-related dermatitis. However, the pathogenicity of these microorganisms has not been revealed at the genetic level owing to the lack of a genetic recombination system. Therefore, we developed a gene recombination system for M. globosa using Agrobacterium tumefaciens-mediated gene transfer of the target gene FKB1, which encodes the FKBP12 protein that binds the calcineurin inhibitor tacrolimus. The wild-type strain of M. globosa was sensitive to tacrolimus, whereas the FKB1 deletion mutant was resistant to tacrolimus. Reintroduction of FKB1 into the FKB1 deletion mutant restored wild-type levels of susceptibility to tacrolimus. Moreover, an FKB1-eGFP fusion gene was generated and expression of this fusion protein was observed in the cytoplasm. This newly developed gene recombination system for M. globosa will help further our understanding of the pathogenesis of M. globosa-related dermatitis at the genetic level. [ABSTRACT FROM AUTHOR]

Competing Interests: Conflicts of interest Dr Lipner has served as a consultant for Ortho-Dermatologics, Eli Lilly, Moberg Pharmaceuticals, and Belle Torus Corporation. Drs Gold and Benedict have no conflicts of interest to declare.

Abstract Aiming at disclosing the semiotic method used in the diagnosis of pityriasis versicolor, the authors go through the history of the creation of Zirelí sign, describing the method, its usefulness and practicality in dermatological clinical practice, whether public or private, and to give credit to the author of this semiological maneuver, in memoriam.

Abstract Background Red scrotum syndrome is typically described as well-demarcated erythema of the anterior scrotum accompanied by persistent itching and burning. It is chronic and difficult to treat and contributes to significant psychological distress and reduction in quality of life. The medical literature surrounding the condition is sparse, with the prevalence likely under-recognized and the pathophysiology remaining poorly understood. Formation of a cutaneous microbial biofilm has not been proposed as an underlying etiology. Microbial biofilms can form whenever microorganisms are suspended in fluid on a surface for a prolonged time and are becoming increasingly recognized as important contributors to medical disease (e.g., chronic wounds). Case presentation A 26-year-old man abruptly developed well-demarcated erythema of the bilateral scrotum after vaginal secretions were left covering the scrotum overnight. For 14 months, the patient experienced daily scrotal itching and burning while seeking care from multiple physicians and attempting numerous failed therapies. He eventually obtained complete symptomatic relief with the twice daily application of 0.8% menthol powder. Findings in support of a cutaneous microbial biofilm as the underlying etiology include: (1) the condition began following a typical scenario that would facilitate biofilm formation; (2) the demarcation of erythema precisely follows the scrotal hairline, suggesting that hair follicles acted as scaffolding during biofilm formation; (3) despite resolution of symptoms, the scrotal erythema has persisted, unchanged in boundary 15 years after the condition began; and (4) the erythematous skin demonstrates prolonged retention of gentian violet dye in comparison with adjacent unaffected skin, suggesting the presence of dye-avid material on the skin surface. Conclusion The probability that microorganisms, under proper conditions, can form biofilm on intact skin is poorly recognized. This case presents a compelling argument for a cutaneous microbial biofilm as the underlying cause of red scrotum syndrome in one patient, and a review of similarities with other reported cases suggests the same etiology is likely responsible for a significant portion of the total disease burden. This etiology may also be a significant contributor to the disease burden of vulvodynia, a condition with many similarities to red scrotum syndrome.

Background: Red scrotum syndrome is typically described as well-demarcated erythema of the anterior scrotum accompanied by persistent itching and burning. It is chronic and difficult to treat and contributes to significant psychological distress and reduction in quality of life. The medical literature surrounding the condition is sparse, with the prevalence likely under-recognized and the pathophysiology remaining poorly understood. Formation of a cutaneous microbial biofilm has not been proposed as an underlying etiology. Microbial biofilms can form whenever microorganisms are suspended in fluid on a surface for a prolonged time and are becoming increasingly recognized as important contributors to medical disease (e.g., chronic wounds). Case presentation: A 26-year-old man abruptly developed well-demarcated erythema of the bilateral scrotum after vaginal secretions were left covering the scrotum overnight. For 14 months, the patient experienced daily scrotal itching and burning while seeking care from multiple physicians and attempting numerous failed therapies. He eventually obtained complete symptomatic relief with the twice daily application of 0.8% menthol powder. Findings in support of a cutaneous microbial biofilm as the underlying etiology include: (1) the condition began following a typical scenario that would facilitate biofilm formation; (2) the demarcation of erythema precisely follows the scrotal hairline, suggesting that hair follicles acted as scaffolding during biofilm formation; (3) despite resolution of symptoms, the scrotal erythema has persisted, unchanged in boundary 15 years after the condition began; and (4) the erythematous skin demonstrates prolonged retention of gentian violet dye in comparison with adjacent unaffected skin, suggesting the presence of dye-avid material on the skin surface. Conclusion: The probability that microorganisms, under proper conditions, can form biofilm on intact skin is poorly recognized. This case presents a compelling argument for a cutaneous microbial biofilm as the underlying cause of red scrotum syndrome in one patient, and a review of similarities with other reported cases suggests the same etiology is likely responsible for a significant portion of the total disease burden. This etiology may also be a significant contributor to the disease burden of vulvodynia, a condition with many similarities to red scrotum syndrome. [ABSTRACT FROM AUTHOR]

Mahesh Mathur,* Prakash Acharya,* Alina Karki, Nisha KC, Jyoti ShahDepartment of Dermatology, College of Medical Sciences, Bharatpur, Nepal*These authors contributed equally to this workBackground: Pityriasis versicolor (PV) is essentially a clinical diagnosis characterized by hypopigmented or hyperpigmented patches on the skin. Dermoscopy is gaining popularity as a noninvasive procedure for the diagnosis of different pigmentary and inflammatory disorders. However, scarce evidence exists on the dermoscopic pattern of PV.Objective: To describe the dermoscopic features of hypopigmented and hyperpigmented lesions of PV.Methods: Dermoscopic images of PV lesions located on different body sites were retrospectively evaluated for the presence of predefined criteria.Results: A total of 178 lesions from 125 patients were included in the study among which 164 lesions were hypopigmented and 14 lesions were hyperpigmented. Nonuniform pigmentation was the most common dermoscopic feature seen in both hypopigmented lesions (n=152, 92.68%) and hyperpigmented lesions (n=14, 100%). Scales were seen in 142 hypopigmented lesions (86.56%) and 13 hyperpigmented lesions (92.86%). Patchy scaling was more common in hypopigmented lesions (n=95, 57.92%) while scaling in the furrows was more common in the dermoscopy of hyperpigmented lesions (n=5, 35.71%). Inconspicuous ridges and furrows and perilesional hyperpigmentation were other significant features seen in dermoscopy of the lesions.Conclusion: To our knowledge, this is the first study describing the dermoscopic features of PV in such a large number of patients. Description of these new features adds valuable information and may help to establish dermoscopy as an important auxiliary tool for the diagnosis of PV.Keywords: dermoscopy, dermatoscopy, tinea versicolor, diagnosis, hypopigmented patches

Background: Pityriasis versicolor (PV) is a superficial mycosis caused by Malassezia yeast; a lipophilic fungus. Dermoscopy may be a value addition in the diagnosis of PV in some cases, where results of KOH (potassium hydroxide) examination are ambiguous. There is paucity of Indian data on dermoscopy of PV. Materials and Methods: Thirty consecutive patients diagnosed clinically with pityriasis versicolor were recruited in this pilot cross sectional study.Patients were subjected to KOH mount of the skin scrapings from the lesions which were positive in all the patients.Dermoscopy was performed in all using Universal Serial Bus (USB) dermoscope [Dinolite AMZT 73915, Edge 3] and features were recorded for analysis. Results: Hypopigmented variant was the most common type (80%). Dermoscopic analysis revealed altered pigmentary network as most common finding (100%) followed by scaling seen in 25 cases (83.33%). Folliculocentric pattern was appreciated in 20 cases (66.67%). A characteristic contrast halo ring around the primary altered pigmentation was observed in 20 cases (66.67%). Invasion of hair follicles by yeast was evident in 6 patients (20%). Conclusion: Dermoscopy with characteristic features such as folliculocentricity, contrast halo sign, and yeast invasion of hair follicles can be a very useful aid in contributing towards diagnosing pityriasis versicolor.

Introduction: Pityriasis Versicolor (PV) a commonly encountered superficial mycosis is a mild, chronic infection of the stratum corneum. Malassezia species are lipid dependent yeast that are commonly found on human skin and associated with PV and dandruff. Aim: To study the distribution of Malassezia species in cases of PV and Dandruff. Materials and Methods: A tertiary care rural hospital based cross-sectional study was undertaken. Skin scrapings were collected and cultured on Sabouraud’s Dextrose Agar (SDA) overlaid with olive oil and modified Dixon agar (mDA). The isolates were identified by biochemical tests. Data was analysed using the Chi-square test. The p-value of

Introduction: Pityriasis Versicolor (PV) a commonly encountered superficial mycosis is a mild, chronic infection of the stratum corneum. Malassezia species are lipid dependent yeast that are commonly found on human skin and associated with PV and dandruff. Aim: To study the distribution of Malassezia species in cases of PV and Dandruff. Materials and Methods: A tertiary care rural hospital based cross-sectional study was undertaken. Skin scrapings were collected and cultured on Sabouraud's Dextrose Agar (SDA) overlaid with olive oil and modified Dixon agar (mDA). The isolates were identified by biochemical tests. Data was analysed using the Chi-square test. The p-value of <0.05 was considered statistically significant. Results: Out of the 127 samples of PV, 38.2% were 10% KOH positive. A total of 76 yielded growth. The most common isolate was M.sympodialis (53.06%), followed by M.furfur (26.53%), M.globosa (16.33%) and M.slooffiae (4.08%). Of the 51 cases of dandruff cases, 27 samples yielded growth and the most common isolate was M.sympodialis (62.96%), followed by M.furfur (25.93%), M.globosa (11.11%). Conclusion: PV and dandruff are the common surface infections in this rural region and Malassezia sympodialis is the commonest species associated with these conditions [ABSTRACT FROM AUTHOR]

Pityriasis versicolor, a common skin fungal infection, is typically observed on trunk and limb skin. Here, we highlight an unusual presentation: scalp involvement, often overlooked due to its asymptomatic, mildly scaly patches. We report four pediatric cases, emphasizing the potential underestimation of this scalp variant. This case series underscores the importance of considering this diagnosis in patients with unexplained scalp hypopigmentation, especially in males with short hair who may readily notice these subtle changes. The report contributes to the understanding of this variant's clinical presentation and emphasizes the need for awareness among clinicians to ensure accurate diagnosis and appropriate management., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Zhou, Chao, Ma and Xiao.)

Background: Tinea versicolor (TV) is characterised by the appearance of maculosquamous lesions sometimes associated with mild erythema and pruritus in characteristic areas of the body. Eberconazole and terbinafine though drugs of different classes provide both mycological and clinical cure. Aim: This study aims to compare the efficacy and safety of eberconazole versus terbinafine in patients of TV. Materials and Methods: An open-label, randomised, comparative clinical trial was conducted on 60 patients. The patients were randomly divided into two study groups. Group A: Eberconazole 1% cream once daily and Group B: Terbinafine 1% cream once daily for 2 weeks. Efficacy assessment was done by observing signs and symptoms, i.e., Physician assessment 4-point scale, microscopic KOH examination, Wood's lamp examination, global clinical response assessment, and patient's assessment on visual analog scale at the end of 2 weeks and subsequently patients were reassessed at the end of 4 and 8 weeks to check any relapse. Safety assessment was also done. Results: There was a significant improvement in all the parameters in both groups over a period of 2 weeks. Both the treatment groups, i.e., eberconazole and terbinafine were found to be safe and efficacious at the end of 2 weeks, and no statistically significant difference was observed between the two groups regarding complete cure, i.e., mycological and clinical cure (80% vs. 63.33%), respectively. However, early response (at the end of week 1) was observed with eberconazole. No relapse was seen with eberconazole, but one patient had relapse at 8 weeks with terbinafine. Both drugs had similar safety profile. Conclusion: Although both the drugs cured the disease, eberconazole showed better response as clinical cure and mycological cure were observed earlier and no patient relapsed in the follow-up.

Background/aim: H. pylori has been found to be related to certain dermatological diseases. However, there is no data as yet to propose an association between H. pylori and pityriasis versicolor. In this study, we aimed to evaluate the association between H. pylori and pityriasis versicolor. Materials and methods: This was a prospective study performed in the Gastroenterology and Dermatology and Venereology departments of the Health Sciences University, Ankara Training and Research Centre. A total of 57 consecutive patients (27 pityriasis versicolor, 30 telogen effluvium) were enrolled from the Department of Dermatology and Venereology. All patients were screened for H. pylori IgG and CagA. In addition, urea breath test was carried out to detect the existence of H. pylori infection. Results: There were significantly higher rates of H. pylori positivity, H. pylori IgG in serum in the pityriasis versicolor group compared to the telogen effluvium group (P < 0.05). In addition, the number of patients with dyspeptic complaints was higher in the pityriasis versicolor group than in the telogen effluvium group. The odds ratio for dyspepsia, H. pylori positivity, and H. pylori IgG were 2.48, 1.67, and 1.78, respectively. Conclusion: In this study, we found a statistically significant relationship between H. pylori infection and pityriasis versicolor. Therefore, H. pylori eradication could be considered in recurrent pityriasis versicolor patients with dyspepsia. New studies are required to clarify the effect of eradication treatment on the clinical course of pityriasis versicolor. [ABSTRACT FROM AUTHOR]

Malassezia furfur (Robin) is considered as a causative agent of pityriasis versicolor. It is also associated with seborrheic dermatitis and dandruff formation, folliculitis, confluent and reticulates papillomatosis, and the provocation of psoriatic lesions. The organism has complex lipid requirements for growth, which also explains its occurrence on the skin. The fungus can grow in a yeast phase as well as in a mycelial phase. Many substances for topical application, such as ketoconazole, fluconazole, minoxidil, ciclopirox-olamine, piroctone-olamine, zinc pyrithione, or sulfur-containing substances are advised in the treatment of these diseases. But the control of this fungus is not satisfactory. Hence, Malassezia furfur lipase (Mflip1) inhibition activity was studied in an in silico docking program with Propanamide, N-methyl-2-amino and 1-Propanol, 3-(dimethylamino) after constructing 3D structure built of Mflip1 by Homology modeling in the PDB database. These two phyto-compounds were found in Hibiscus rosa-sinensis flower and leaf ethanolic extracts by GC-MS analysis. The docking results indicated suitable binding of the active site cavity of Malassezial lipase (Mflip1) and caused conformational changes as inhibitory effect by propanamide compounds. [ABSTRACT FROM AUTHOR]

Abstract Superficial mycoses are fungal infections restricted to the stratum corneum and to the hair shafts, with no penetration in the epidermis; they are: white piedra, black piedra, tinea versicolor, and tinea nigra. This study presents images of mycological tests performed in the laboratory, as well as exams performed at the authors office, in order to improve the dermatologist's knowledge about the diagnosis of these dermatoses, which are common in many countries.

Background: Pityriasis versicolor is a common fungal infection of the superficial skin layer caused by Malassezia furfur , a normal commensal in the skin. Keratolytic agents are popular, cheap, and readily available over-the-counter treatments for pityriasis versicolor. Conventional antifungal agents are more expensive, requiring prescription, and may induce resistant strains. However, evidence of their comparative safety and efficacy is still lacking., Objectives: To assess the efficacy and safety of synthetic antifungals compared to keratolytic agents in the topical treatment of pityriasis versicolor through a systematic review., Methods: We searched the following databases: MEDLINE (from 1966) through PubMed, CENTRAL (Issue 9 of 12, September 2021), EMBASE (from 1974), LILACS (from 1987); Herdin (from 1970), www.clinicaltrials.gov, www.isrctn.com, www.trialregister.nl. We contacted researchers in the field, hand searched relevant conference abstracts, and the Journal of the Philippine Dermatological Society 1992-2019. We included all randomized controlled trials involving patients with diagnosed active pityriasis versicolor where topical antifungal was compared with a topical keratolytic for treatment. Two review authors independently applied eligibility criteria, assessed risk of bias using the Cochrane collaboration tool, and extracted data from included studies. We used RevMan 5.3 to pool dichotomous outcomes using risk ratios (RR) and continuous outcomes using the mean difference (MD), using random-effects meta-analysis. We tested for statistical heterogeneity using both the Chi² test and the I² test. We presented results using forest plots with 95% confidence intervals. We planned to create a funnel plot to determine publication bias but were unable to due to few studies. A Summary of Findings table was created using GRADE profile software for the primary outcomes., Results: We included 8 RCTs with a total of 617 participants that compared azole preparations (ketoconazole, bifonazole and econazole) versus keratolytic agents (selenium sulfide, adapalene, salicylic-benzoic acid). Pooled data showed that azoles did not significantly differ from keratolytic agents for clinical cure (RR 0.99, 0.88, 1.12; 4 RCTs, N=274, I 2 =55%; very low-quality evidence), and adverse events (0.59 [0.17, 2.06]; very low-quality evidence) based on 6 RCTs (N=536). There were two patients given a keratolytic agent (selenium sulfide shampoo) who had acute dermatitis and discontinued treatment., Conclusion: It is uncertain whether topical azoles are as effective as keratolytic agents in clinical clearance and occurrence of adverse events in patients with pityriasis versicolor. A wider search of grey literature and local studies are warranted. Larger RCTs with low risk of bias are recommended., Competing Interests: All authors declare that there is no conflict of interest., (© 2024 Acta Medica Philippina.)

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. [ABSTRACT FROM AUTHOR]

Purpose of Review: Pityriasis versicolor (PV) is a superficial mycosis that it can occur at any age, even in newborns. In this review, we will describe epidemiological data, mycological characteristics of yeast, pathogenesis and clinical characteristics of the disease, different diagnostic resources, and the current recommendations for treatment. Recent Findings: The typical morphology and topography of PV allow us to make a quick diagnosis, but atypical presentations have been described. Diagnostic tools, such as dermoscopy, can also reveal patterns that allow the evaluation of characteristics of scales and pigment in lesions. The discovery of new species and new mechanisms of interaction with the host has broadened the panorama of aetiological possibilities. Summary: Although PV is a common disorder, extensive research is necessary to better understand the pathophysiology of the disease, immunological characteristics of the pathogen-host relationship and resources needed to precisely diagnose the disease, treat the disease, and avoid its chronic and recurrent course. [ABSTRACT FROM AUTHOR]

Background: Pityriasis versicolor (PV) is a superficial mycosis caused by Malassezia yeast; a lipophilic fungus. Dermoscopy may be a value addition in the diagnosis of PV in some cases, where results of KOH (potassium hydroxide) examination are ambiguous. There is paucity of Indian data on dermoscopy of PV. Materials and Methods: Thirty consecutive patients diagnosed clinically with pityriasis versicolor were recruited in this pilot cross sectional study.Patients were subjected to KOH mount of the skin scrapings from the lesions which were positive in all the patients.Dermoscopy was performed in all using Universal Serial Bus (USB) dermoscope [Dinolite AMZT 73915, Edge 3] and features were recorded for analysis. Results: Hypopigmented variant was the most common type (80%). Dermoscopic analysis revealed altered pigmentary network as most common finding (100%) followed by scaling seen in 25 cases (83.33%). Folliculocentric pattern was appreciated in 20 cases (66.67%). A characteristic contrast halo ring around the primary altered pigmentation was observed in 20 cases (66.67%). Invasion of hair follicles by yeast was evident in 6 patients (20%). Conclusion: Dermoscopy with characteristic features such as folliculocentricity, contrast halo sign, and yeast invasion of hair follicles can be a very useful aid in contributing towards diagnosing pityriasis versicolor. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The potency of local peanut can be utilized as fungi growth medium to substitute Potato Dextrose Agar media (PDA). Peanuts are widely found in East Java and there are 7 varieties, namely Takar-1, Takar-2, Tuban, Jerapah, Talam-1, Hypoma-2, and Bima. This study aimed to make modified media from nuts for growth of Candida albicans, and Tinea versicolor. The type of this research was exploratory design. Peanut Sucrose Agar (PSA) medium was made from 8 local peanut varieties, sucrose, agar, chloramphenicol. As a gold standard media used PDA and Sabaroud Dextrose Agar (SDA). The mediums were planted with Candida albicans, and Tinea versicolor, to analyze colony diameter, morphological features and storability PSA media. The largest diameter of Candida albicans colonies and the highest number of Tinea versicolor colonies were obtained in PSA from Talam-1 variety when compared with PDA and SDA media. There was no difference in morphological of Candida albicans features and Tinea versicolor on PSA, PDA and SDA media. Storability of PSA, PDA and SDA media for 1 month at 4°C does not cause macroscopic media changes. Local peanut varieties Talam-1 was the best variety as the base material for the manufacture of PSA media for the growth of Candida albicans and Tinea versicolor. [ABSTRACT FROM AUTHOR]

One of the commonly encountered skin disorders seen in daily clinical practice is the benign superficial fungal skin infection known as tinea versicolor or pityriasis versicolor. Clinically it presents as macules with fine scales that are either hypopigmented or hyperpigmented involving most often the neck, upper extremities, and the trunk. However, because of the high rate of recurrence and frequent failure of response accompanying usual mode of treatment, several agents are tried now and then, and one of these agents that have been evaluated for treating tinea versicolor is topical 1% diclofenac gel. In the current randomized controlled clinical trial we are aiming to compare the response of tinea versicolor to diclofenac gel in comparison with clotrimazole cream in a sample of Iraqi patients suffering the disease. The present randomized controlled clinical trial included 40 tineaVersicolor patients with an age range of 19 to 42 years. Those patients were randomly selected from the pool of patients visiting the dermatology department at Al-Diwaniyah teaching hospital in Al-Diwaniyah province, Mid-Euphrates region of Iraq. Patients were diagnosed by dermatology specialist and were randomly allocated into two groups, 20 patients each. The first group served as a study group, and the patients received 1% diclofenac gel based ontwo times a day for one month. Patients in the second group, the control group, were given the usual clotrimazole cream, two times daily for one month. There was a highly significant difference in response to treatment between both groups two weeks after surgery in such a way that clotrimazole resulted in more complete response than diclofenac gel, 65% versus 20%, respectively (P = 0.008). Moreover, there was a significant difference in response to treatment between both groups four weeks after treatment in such a way that clotrimazole resulted in more complete response than diclofenac gel, 90% versus 50%, respectively (P = 0.019).It appears that diclofenac topical 1% gel is fairly effective in the treatment of pityriasis versicolor; however, other agents such as clotrimazole are more effective, and hence diclofenac topical 1% gel may be used as an adjuvant form of treatment rather than the sole treatment modality. [ABSTRACT FROM AUTHOR]

Purpose of Review: To address the latest treatments used for pityriasis versicolor and identify those that have proven to be effective in recent publications.Recent Findings: Even though Malassezia spp. have shown resistance to antifungals, classical treatments continue to be effective, and other novelty therapies including light therapies have shown promising results in the treatment of this condition.Summary: Pityriasis versicolor is a common superficial fungal infection of the skin. There are numerous and diverse topical and systemic therapeutic options that are successful for the treatment and prophylaxis of this mycosis. New substances that act against the fungus through other mechanisms of action different from those used until now are expected in the near future. [ABSTRACT FROM AUTHOR]

Solid lipid nanoparticles (SLNs) are very potential formulations for topical delivery of antifungal drugs. Hence, the purpose of this research was to formulate the well-known antifungal agent Fluconazole (FLZ)-loaded SLNs topical gel to improve its efficiency for treatment of Pityriasis Versicolor (PV). FLZ-SLNs were prepared by modified high shear homogenization and ultrasonication method using different concentration of solid lipid (Compritol 888 ATO, Precirol ATO5) and surfactant (Cremophor RH40, Poloxamer 407). The physicochemical properties and the in vitro release study for all FLZ-SLNs were investigated. Furthermore, the optimized FLZ-SLN formula was incorporated into gel using Carpobol 934. A randomized controlled clinical trial (RCT) of potential batches was carried out on 30 well diagnosed PV patients comparing to market product Candistan® 1% cream. Follow up was done for 4 weeks by clinical and KOH examinations. The results showed that FlZ-SLNs were almost spherical shape having colloidal sizes with no aggregation. The drug entrapment efficiency ranged from 55.49% to 83.04%. The zeta potential values lie between −21 and −33 mV presenting good stability. FLZ showed prolonged in vitro release from SLNs dispersion and its Carbapol gel following Higuchi order equation. Clinical studies registered significant improvement (p < .05) in therapeutic response (1.4-fold; healing%, 4-fold; complete eradication) in terms of clinical cure and mycological cure rate from PV against marketed cream. Findings of the study suggest that the developed FLZ loaded SLNs topical gels have superior significant fast therapeutic index in treatment of PV over commercially available Candistan® cream. [ABSTRACT FROM AUTHOR]

Summary: A cross‐sectional descriptive study was conducted at a dermatology referral centre in Bogotá, to estimate the frequencies and aetiologies of mycoses in the population under 18 years of age attending the medical mycology laboratory over a 13‐year period (2000‐2012). A total of 1337 samples from 1221 patients were evaluated, involving direct examination and culture for 1279 samples, direct examination alone for 50 and culture alone for 8. During the study period, dermatophytosis was diagnosed via culture in 537 cases (40.1%). The most common aetiological agents were Trichophyton rubrum (235 cases), Microsporum canis (177), Trichophyton mentagrophytes (74) and Microsporum gypseum (22). Pityriasis versicolor was found in 31 cases (5.1%), Candida spp. were found in 17 cases, and non‐dermatophyte moulds were confirmed by a second sample in 6 cases (3 cases involving Fusarium spp., 2 Neoscytalidium dimidiatum and 1 Acremonium spp.). In addition, white piedra was diagnosed in 4 cases (0.7%), and tinea nigra in 2 cases (0.3%). Regarding subcutaneous mycoses, 14 cases of sporotrichosis were identified. The results from this study confirm the predominance of dermatophytosis in the paediatric population. T. rubrum and M. canis were the main aetiological agents. We found a few cases of onychomycosis by non‐dermatophyte moulds. Sporotrichosis was the only subcutaneous mycosis diagnosed during the study period. [ABSTRACT FROM AUTHOR]