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Lichenoid pityriasis comprises a clinicopathological spectrum of inflammatory skin disorders known as chronic lichenoid pityriasis (PLC), acute lichenoid pityriasis and varioliform pityriasis (PLEVA), and Mucha-Habermann febrile ulceronecrotic disease. PLEVA is a condition with an unknown origin, incidence, and prevalence; however, infections are considered the most common cause, with some vaccines and medications being secondary etiologies to consider. Pharmacological management is not mandatory, and its goal is to expedite recovery and improve symptoms. We present the case of a 58-year-old male patient who sought medical attention for lesions consisting of macules, plaques, and crusts located on the trunk and proximal extremities. Skin biopsy revealed an atypical lymphoid infiltrate in the epidermis with annex destruction consistent with acute lichenoid and varioliform pityriasis of unknown etiology, subsequently treated with systemic antibiotics and topical petroleum jelly on the lesions, resulting in satisfactory improvement. [ABSTRACT FROM AUTHOR]

Background: The underlying pathogenesis of pityriasis lichenoides et varioliformis acuta (PLEVA) remains unclear, although immunologic injury and viral etiology have been suggested. Objective: To evaluate and expand the immunophenotype of PLEVA and to search for possible viral pathogens. Methods: Formalin‐fixed, paraffin‐embedded specimens of 20 patients with PLEVA and 9 patients with common inflammatory dermatoses (ID) were studied for immunophenotyping and for human herpesvirus (HHV) 1 and 2, cytomegalovirus (CMV), HHV‐8, parvovirus B19, and Epstein–Barr virus (EBV) immunohistochemistry. The presence of HHV‐6, HHV‐7, and enteroviruses was assayed molecularly. Results: The numbers of CD8+ T cells and T‐cell intracellular antigen‐1 (TIA‐1)+ cells were statistically significantly higher in PLEVA compared to the ID group. Immunohistochemistry for human HHV‐1 and HHV‐2, CMV and HHV‐8, parvovirus B19, and in situ hybridization for EBV were all negative. There was molecular evidence for HHV‐7 in only one PLEVA case (5%). Molecular studies for HHV‐6 and enterovirus involvement were negative in all the PLEVA specimens. Conclusions: The predominant T‐cell infiltrate in PLEVA is dominated by CD8+ cells, and by increased numbers of TIA1+ cells, which may indicate a cytotoxic T‐cell damage to the epidermis. Viral presence was not detected. [ABSTRACT FROM AUTHOR]

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In the wake of a global COVID-19 pandemic, where innovations in vaccination technology and the speed of development and distribution have been unprecedented, a wide variety of post-vaccination cutaneous reactions have surfaced. However, there has not been a systematic review that investigates pityriasis eruptions and the associated variants following COVID-19 inoculations. A PubMed search using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was performed to find case reports from the earliest record through November 2022. Data including types of vaccination and pityriasis were extracted and a quality review was performed. 47 reports with 94 patients were found: 64.9% had pityriasis rosea (PR), 3.2% PR-like eruptions, 16.0% pityriasis rubra pilaris (PRP), 7.4% pityriasis lichenoides et varioliformis acuta (PLEVA), 3.2% pityriasis lichenoides chronica (PLC), and 5.3% had reactions described as “atypical”. The top three COVID-19 vaccinations reported were Pfizer-BioNTech (47.9%), Oxford-AstraZeneca (11.7%), and Moderna (8.5%). Pityriasis reactivity was reported most frequently after the Pfizer-BioNTech vaccination, with pityriasis rosea being the most common variant. A large difference was additionally found between the ratio of post-vaccination pityriasis reactions following Pfizer and Moderna vaccinations (5.63), and the ratio of Pfizer’s usage in the United States as of December 28, 2022 relative to that of Moderna (1.59). Further studies with adequate follow-up periods and diagnostic testing will thus need to be performed to elucidate the root of this discrepancy and better characterize the association between different pityriasis reactions and COVID-19 vaccinations.

Background: Pityriasis alba (PA) is a common, benign skin disorder occurring predominantly in children and adolescents. It is characterized by the presence of multiple, ill-defined, hypopigmented patches with fine scaling particularly over the face. Aims and objectives: To study the clinical characteristics and epidemiologic parameters in the context of current scenario in a rural tertiary care hospital in central India. Materials and methods: We conducted a descriptive observational study over a period of 1 year. We studied 100 clinically diagnosed patients with PA of the age group 2 to 15 years during this study. Results: Most common age group of patients observed was 6 to 10 years. About 87% patients had Fitzpatrick skin type IV followed by type III (7%) and type V (6%). Male to female ratio was 1.17:1. Maximum patients belonged to class III (50%) followed by class IV (37%) and class V (10%) according to the modified Kuppuswamy socioeconomic status scale (2018). Maximum patients had age of onset ranging from 6 to 10 years. Clinical characteristics revealed that maximum patients had 0 to 5 patches, with a duration of 1 to 2 months most commonly over cheeks. Associated features such as itching, scaling, and erythema were present in 18%, 98%, and 1% of the patients, respectively. Pallor was observed in 28% patients. However, significant history of atopy was elucidated in only 21% of patients. Around 6% patients showed positive family history of having PA and 14% having a positive history of atopy in first-degree family members. Conclusion: Due to the easily visible hypopigmented patches most commonly over face, PA is a common cause of concern in pediatric age group. In recent times, possibility of multiple factors other than atopy should be kept in mind while thinking of the associating or implicating factors which will lead to proper management of this pigmentary disorder.

Background: Pityriasis alba (PA) is a common, benign skin disorder occurring predominantly in children and adolescents. It is characterized by the presence of multiple, ill-defined, hypopigmented patches with fine scaling particularly over the face. Aims and objectives: To study the clinical characteristics and epidemiologic parameters in the context of current scenario in a rural tertiary care hospital in central India. Materials and methods: We conducted a descriptive observational study over a period of 1 year. We studied 100 clinically diagnosed patients with PA of the age group 2 to 15 years during this study. Results: Most common age group of patients observed was 6 to 10 years. About 87% patients had Fitzpatrick skin type IV followed by type III (7%) and type V (6%). Male to female ratio was 1.17:1. Maximum patients belonged to class III (50%) followed by class IV (37%) and class V (10%) according to the modified Kuppuswamy socioeconomic status scale (2018). Maximum patients had age of onset ranging from 6 to 10 years. Clinical characteristics revealed that maximum patients had 0 to 5 patches, with a duration of 1 to 2 months most commonly over cheeks. Associated features such as itching, scaling, and erythema were present in 18%, 98%, and 1% of the patients, respectively. Pallor was observed in 28% patients. However, significant history of atopy was elucidated in only 21% of patients. Around6%patients showed positive family history of having PA and 14% having a positive history of atopy in first-degree family members. Conclusion: Due to the easily visible hypopigmented patches most commonly over face, PA is a common cause of concern in pediatric age group. In recent times, possibility of multiple factors other than atopy should be kept in mind while thinking of the associating or implicating factors which will lead to proper management of this pigmentary disorder. [ABSTRACT FROM AUTHOR]

Dandruff and scalp discomfort are common concerns for women and men in Africa. Moreover, women with afro-textured hair are prone to scalp discomfort owing to irregular hair washing, frequent use of oil-based products on their scalp, and harsh chemical treatments. Current literature does not, however, provide data on the pathophysiological mechanisms of these conditions in this population. In this study, we investigated the mechanisms behind scalp discomfort and dandruff in women of African descent before and after hair washing. We conducted the in Durban, South Africa, over a 3-week period with 60 women of African descent aged 20-40 years. The respondents were equally divided into a "dandruff" and a "no dandruff" group, based on clinical grading of adherent dandruff by a dermatologist. Malassezia spp. and bacterial loads were quantified by quantitative polymerase chain reaction. Evaluations of scalp condition and sample collection were performed at five time points during the 3 weeks. Data on discomfort symptoms were collected via a self-assessment questionnaire. We observed that the dandruff severity peaked at the end of the first week after hair washing and plateaued from thereon in both groups. Dandruff was associated with higher Malassezia and bacterial load counts and there was a direct correlation between the Malassezia spp. load and dandruff score. Via self-assessment questionnaire responses submitted by participants, we observed that itching was the most pronounced scalp discomfort, compared with the sensation of tingling and burning at baseline, while an improvement of the scalp symptoms of dandruff and itch was observed in both groups after one hair wash. The study also showed that higher colonization with Malassezia spp. and bacteria is associated with dandruff independently of the time point, confirming a scalp microbiome contribution to the dandruff pathophysiology in the study population. The benefits of washing were, however, not sustained after 1 week and we thus recommend weekly hair washing for long-term management of dandruff and scalp itchiness in this population., (© 2024 Japanese Dermatological Association.)

Pityriasis Rubra Pilaris is a rare, chronic inflammatory dermatosis of unknown etiology, presenting with erythema and papular eruptions. Treatment is difficult due to the lack of causal therapy, guidelines and requires an individualized approach. The most common treatments are systemic retinoids, immunosuppressants, phototherapy and biological therapy. This article presents the case of a 73-year-old man suffering from type 1 pityriasis rubra pilaris. The patient was initially treated with acitretin, which was discontinued due to hypogammaglobulinemia. This rare side effect of acitretin has not been previously published. As a second-line treatment, the patient received methotrexate, but with no clinical improvement after 3 months and an increase in skin pruritus. Finally, the use of isotretinoin resulted in significant clinical improvement and was well tolerated.