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BACKGROUND: Pityriasis versicolor (PV) is a common superficial fungal disease. Possibility of emergence of resistant strains to azoles, and difficulty in differentiation of hypopigmented PV and early vitiligo, encouraged us to evaluate the efficacy of topical tacrolimus (a calcineurin inhibitor agent with proven in vitro anti-Malassezia effect) for PV treatment generally and its effect on PV-induced hypopigmentation specifically. OBJECTIVES: To evaluate the efficacy of topical tacrolimus on pityriasis versicolor. PATIENTS/METHODS: Fifty PV patients were randomly allocated into two equal groups applying either topical clotrimazol or tacrolimus twice daily for 3 weeks. They were evaluated at the beginning of study, in the third and fifth weeks clinically and mycologically (direct smear). RESULTS: Although both treatments resulted in global, clinical, and mycological cure of PV, there was no significant difference regarding the mentioned aspects of cure between tacrolimus and clotrimazole treated patients. (P-value: .63, .45, and .26, respectively) Tacrolimus had no significant effect on hypopigmentation in the fifth week follow-up. (P-value: .62). CONCLUSIONS: In spite of the lack of efficacy of tacrolimus on PV-induced hypopigmentation, the therapeutic effect on PV introduces tacrolimus as a therapeutic option for PV, especially when early vitiligo is among the differential diagnoses without concerning the aggravating effect of topical corticosteroids on PV.

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Fungal infections of the genitals are probably more common than realized; however, relatively few reports concerning fungal genital infections exist in the literature. In this review, the fungal microbiota of the penis are highlighted, and the epidemiological characteristics of Candida balanitis, penile pityriasis versicolor, and tinea genitalis are addressed. In addition, the benefits of circumcision on male genital infections are included. However, systemic mycoses affecting the penis and/or scrotum will not be addressed in this review. To obtain a reliable diagnosis of genital fungal infections, medical history, clinical examination, and mycological and histological investigations of the lesions are critical.

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Dandruff (also called Pityriasis capitis) is a seborrhoeic dermatitis of the scalp. It has been correlated with the pathological colonization of the scalp with yeast from the genus Malassezia; this illness has a worldwide distribution and represents 25% of all scalp dermatosis cases. It has been demonstrated that the extract obtained from leaves of the plant Solanum chrysotrichum possesses biological activity against dermatophytes and yeast. Different steroidal saponins with antimycotic activity have been isolated from the active extract. Clinical trials with standardized extracts prepared with this vegetal species report high rates of clinical and mycological effectiveness in the treatment of Tinea pedis,without producing secondary effects. The aim of this randomized, double blind and controlled clinical study, was to compare the therapeutic effectiveness and tolerability of a shampoo containing a standardized extract of S. chrysotrichum (applied every third day, for 4 weeks), against 2% ketoconazole in the topical treatment of Pityriasis capitis. From a total of 120 patients with the clinical diagnosis of Pityriasis capitis, 14 subjects were eliminated because the presence of Malassezia was not proved, an-other two patients withdrew from the study due to non-medical causes and one more withdrew because Tinea capitis was diagnosed. Therefore, the final analysis included 51 subjects in the experimental group and 52 in the control; in 45.6% of the cases M. furfur was identified as the pathogenic agent, in 44.66% M. globosa was isolated, and 9.71 % of the patients had a mixed infestation. At the end of the treatment period, the prepared phytopharmaceutical with the standardized extract from S. chrysotrichum achieved a clinical effectiveness (total absence of signs and symptoms produced by Pityriasis capitis) of 92.16%;the mycological effectiveness (absence of Malassezia spp. in the direct examination and culture) was 68.63 %; whilst the tolerability (absence of side effects that prompt subjects to abandon the treatment) was 100%. The therapeutic success (clinical and mycological effectiveness plus tolerability) was 64.71%. The comparison of these results with that obtained from the group treated with 2% ketoconazole, showed no significant differences (Z2, p >0.23). These results show the therapeutic effectiveness and tolerability of the standardized extract from S. chrysotrichum on the local treatment of Pityriasis capitis associated with the yeast of the genus Malassezia.

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BACKGROUND: Studies on pityriasis amiantacea (PA) in the literature are limited and mostly retrospective. We prospectively analyzed the clinical and etiopathologic factors in a large series of PA diagnosed at our department within a defined period (2000-01). METHODS: All PA patients who attended our department were evaluated clinically and underwent bacteriologic, mycologic, and histopathologic examinations. Forty healthy control persons were similarly subjected to bacteriologic and mycologic investigations of their scalp hairs. RESULTS: A total of 85 PA patients were collected and studied. Pathological diagnosis of scalp psoriasis was confirmed in 35.3% of cases. Eczematous features suggesting a diagnosis of seborrheic and atopic dermatitis were detected in 34.2%. Diagnosis of tinea capitis, diagnosed by potassium hydroxide preparation, fungal culture, and periodic-acid Schiff staining, was detected in 12.9% of the PA patients. Staphylococcus isolates were detected in 96.5% of the PA patients compared with 15% in healthy persons as the control (P > 0.00001). CONCLUSIONS: Pityriasis amiantacea represents a particular reaction pattern of the scalp to various inflammatory scalp diseases. The most frequent skin diseases associated with PA are psoriasis and seborrheic dermatitis. It is important to keep the diagnosis of tinea capitis in mind when evaluating PA patients. Staphylococci on the scalp could participate in the pathogenesis of PA.

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Bioassay directed fractionation of crude extract from Mahonia aquifolium led to the isolation of fraction A (bisbenzylisoquinoline alkaloid complex, BBI) and a fraction of protoberberine alkaloids, where the major compounds berberine and jatrorrhizine were isolated as their iodides. The antifungal activity of the crude extract, two protoberberine alkaloids and BBI from M. aquifolium stem bark were evaluated against six strains of Malassezia spp. The compounds tested were generally found to possess only weak to moderate antifungal properties: the MICs for individual strains were in the range < or = 50-> or = 1000 mg/L.

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We report three patients, two infants and an adult, in whom their tinea capitis clinically appeared as pityriasis amiantacea. The mycological studies showed infection due to Microsporum canis in all cases. Correct diagnosis as well as adequate antimycotic chemotherapy of this atypical manifestation of tinea capitis remain a challenge to the clinician. Epidemiological aspects must be regarded also.

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BACKGROUND: Pityriasis rotunda (PR) is an uncommon dermatosis characterized by multiple, round or oval, sharply demarcated scaling patches that are dyschromic and asymptomatic. It has been described in Japanese and in blacks, usually in association with certain infective or malignant systemic diseases. OBJECTIVE: The aim of this study is to further clarify this rare entity which in Italy seems to be confined to the island of Sardinia. METHODS: We studied 42 Sardinian patients, 22 males and 20 females, in an age range of 3-32 years. In 29 cases, the disease involved more than one family member. The patients were observed in Cagliari, the capital city of Sardinia. RESULTS: Bacterial, viral and fungal investigation yielded negative results. Haematochemical and immunological examination and thyroid, hypophyseal and adrenal hormones did not reveal any alterations. No systemic pathologies were found associated with the disease. CONCLUSIONS: The cases studied by us and those previously reported seem to indicate the presence of two distinct types of PR with significant prognostic differences.

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Pityriasis capitis is improved by the use of antifungal shampoos. A double-blind randomized, placebo-controlled study was conducted to compare the efficacy of ketoconazole 0.5 percent and 1 percent formulation shampoos. Evaluations were made in seventy-eight volunteers before and after a two-week duration of daily shampooing. Grading the Malassezia ovalis load in dandruff and values of squamometry were used as noninvasive methods to evaluate efficacy.

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Se realizó un estudio sobre la prevalencia de microorganismos causantes de pitiriasis versicolor en pacientes con lesiones cutáneas sugestivas, en una consulta ambulatoria en una zona urbano-marginal de Caracas, los resultados de esta investigación señalan que de 250 pacientes, 75 presentaron lesiones en la piel, sospechosas de pitiriasis versicolor, de los cuales en 23 se identificó Malassezia. 22 M. furfur y en solo 1 caso M. ovalis no hubo diferencias significativas en la prevalencia entre los diferentes grupos etarios y por sexo. Se observó un claro predominio de las lesiones localizadas en la cara (82,2//), de manera aislada (43,48//), o asociadas a lesiones en tronco (26,09//) o miembros superiores (13,04//), sobre otras regiones anatómicas

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Five strains of Malassezia pachydermatis isolated from small animals in Bratislava were subcultured, maintained under sterile paraffin oil and preserved in liquid nitrogen. Morphological and physiological characteristics as well as the analysis of long chain fatty acids of the cell mass were determined. The results showed that the maintenance in liquid nitrogen is the most satisfactory method of preservation of pure cultures of Malassezia pachydermatis.

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Se investigaron zonas no habituales consideradas como posibles reservorios de P.ovale (surco retroauricular y conducto auditivo externo, surco naso geniano, límite del cuero cabelludo con zona frontal, pubis, miembros inferiores, piel sana de tronco) en 50 pacientes con pitiriasis versicolor y con análisis micológicos positivos para P.ovale en esas zonas. Los análisis micológicos en todos los pacientes se repitieron a los 30 y 60 días siguientes al tratamiento. Un 24 por cento dio micología positiva a los 30 días, y el 16,5 por cento a los 60 días. En todos los pacientes predominó la forma levaduriforme de P.ovale. Paralelamente se seleccionó al azar un grupo control de 20 pacientes sin manifestaciones clínicas de P.versicolor. Se estudiaron las mismas zonas no habituales y se encontraron reservatorios de P.ovale en el 40 por cento de los casos. Nuestro estudio tiende a enfatizar la necesidad de buscar P.ovale (M.furfor) en zonas no habituales y efectuar tratamiento local para evitar posibles recidivas

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Se investigaron zonas no habituales consideradas como posibles reservorios de P.ovale (surco retroauricular y conducto auditivo externo, surco naso geniano, límite del cuero cabelludo con zona frontal, pubis, miembros inferiores, piel sana de tronco) en 50 pacientes con pitiriasis versicolor y con análisis micológicos positivos para P.ovale en esas zonas. Los análisis micológicos en todos los pacientes se repitieron a los 30 y 60 días siguientes al tratamiento. Un 24 por cento dio micología positiva a los 30 días, y el 16,5 por cento a los 60 días. En todos los pacientes predominó la forma levaduriforme de P.ovale. Paralelamente se seleccionó al azar un grupo control de 20 pacientes sin manifestaciones clínicas de P.versicolor. Se estudiaron las mismas zonas no habituales y se encontraron reservatorios de P.ovale en el 40 por cento de los casos. Nuestro estudio tiende a enfatizar la necesidad de buscar P.ovale (M.furfor) en zonas no habituales y efectuar tratamiento local para evitar posibles recidivas (AU)

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Pityrosporum pachydermatis could be isolated out of a smear taken from the auditory meatus. The occurrence of this zoophilic species prompted us to discuss the systematic position and nomenclature of pityrosporum yeasts in man.

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Se presentan 2,336 casos de dermatomicosis observados en el periodo 1976-1980 en el Laboratorio de Micología de la Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia. El diagnóstico de dermatofitosis se comprobó en 1.276 casos (52.1 por ciento); candidiasis se presentó en 870 casos (35.5 por ciento), pitiriasis en 150 casos (6.1 por ciento), tricosporiasis en 90 casos (3.7 por ciento), geotricosis en 52 casos (2.1 por ciento) y varios en 13 casos (0.5 por ciento); de estos últimos es de resaltar el aislamiento de dos casos de M. persicolor y dos de T. verrucosum. El dermatofito más frecuentemente aislado fue el T. mentagrophytes (32.7 por ciento) seguido por el T. rubrum (23.0 por ciento), el E. floccosum (21.7 por ciento), el T. tonsurans (11.7 por ciento) y en último lugar los Microsporum sp. (10.9 por ciento)

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