MODERN VIEW TO PITYRIASIS VERSICOLOR: SOME ASPECTS OF PATHOGENESIS AND CLINICAL FEATURES IN CONDITIONS OF TORRID CLIMATE
1Department of dermatovenereology, Avicenna Tajik State Medical University, Dushanbe, Tajikistan
Objective: Identify perspiration, skin pH, and clinical features in patients with pityriasis versicolor in conditions of torrid climate.
Methods: In the period of 2008-2011 years, there were 110 patients examined with the diagnoses of pityriasis versicolor (Pityrosporum) in the local clinical hospital No. 1, in Dushanbe.They were 63.6% men (70 persons), and 36.4% – of them women (40 persons), which part of them were rural residents 53.6%, and others were urban residents – 46.4%. The highest number of cases of diseases has mentioned with people in the age of 17 to 35 years (80.9%). Control group comprised to 30 healthy persons. The diagnosis of pityriasis versicolor was determined based on positive Besnier’s symptoms, Balzer tests, yellowish-brown fluorescence at Wood’s light, as well as revealing of a typical microscopic picture of “spaghetti and meatballs”. Colorimetric method was used to determine the skin pH. For quality assessment of perspiration intensity in patients with pityriasis versicolor was used perspiration indicator IIP-01.
Results: Erythematic-squamosal form was the most frequent recorded forms (73.7%) among the 9 clinical types. The expanded version of the pityriasis versicolor with typical localization of the affected areas made 80.9%, hyperpigmental form prevailed over hypopigmental form. Rare atypical forms of the disease (white spot type, erythrasmoid, urticarioid, lichenoid, ring-shaped, obliterated) were recorded in 11.8% of cases. 20.9% of patients had atypical localization of the pathological disease process on the face skin, axillary cavities, inframammary crease, inguinal fold, clunis, genitals, poples, dorslims of hands. In comparison with healthy persons which indicates perspiration and pH indicators 51.8 mA±0,46 and 5,33±0,004, patients with pityriasis versicolor had higher perspiration and pH in all tested areas and made the average of 60.1 мА±0,2 and 6,23±0,003 accordingly.
Conclusions: Pityriasis versicolor is clinically polymorphyc. Along with the frequent forms, there are atypical forms with unusual localization of the disease process that may lead to diagnostic errors. Increased perspiration in torrid seasons causes to shift the skin pH in terms of alkaline content, and creates favorable environment for dissemination of Malassezia furfur.
Keywords: Pityriasis versicolor, perspiration, pH, clinical development, atypical form.
- Karakas M. Epidemiology of Pityriasis Versicolor in Adana, Turkey. Journal of Dermatology. 2009;36:377-82.
- Moralis PM, Moreira Frota Z, Souza Cunha MG. Clinical aspects of patients with pityriasis versicolor seen at a referall center for tropical dermatology in Manaus, Amazonas, Brazil. An. Bras Dermatol. 2010; 85(6):790- 803.
- Chosh SK. Pityriasis versicolor: A clinicomycological and epidemiological study from a tertiary care hospital. Indian J of Dermatol. 2008;53:182-5.
- Giusiano G. Prevalence of Malassezia specie in pityriasis versicolor lesions in Argentina. Revista Iberoamericana de Micologia. 2010;27(2):71-4.
- Salahi-Moghaddam. Evalution of pityriasis versicolor in prisoners: A crosssectional study. Indian J of Dermatology, Venerology and Leprology. 2009; 75(4):379-82.
- Kutasevich YaF. K voprosu ob atipichnykh formakh mikozov gladkoy kozhi [To the question of atypical forms of smooth skin mycoses]. Dermatologiya ta venerologiya. 2015;4:96-101.
- Framil VMS. New aspects in the clinical course of pityriasis verzicolor. An Bras Dermatol. 2011;86(6):1135-40.
- Tarasooie B. Study of the distribution of Malassezia species in patients with pityriasis versicolor and healthy individuals in Tehran, Iran. B.M.C.Dermatology. 2004;4:1-6.
- Diffonzo EM, Faggi E. Skin diseases associated with Malassezia species in humans. Clinical features and diagnostic criteria. Parassitologia. 2008; 50(1-2):69-71.
- Framil VMS. Pityriasis versicolor: isolation and identification of the main species of Malassezia. An Bras Dermatol. 2010;85(1):111-4.
- Kotrekhova LP. Otrubevidnyy lishay [Pityriasis versicolor]. Vestnik dermatologii i venerologii. 2016;2:104-9.
- Pankratov VG, Pankratov AO, Khudobokova NN. K voprosu o klinike, diagnostike i lechenii otrubevidnogo lishaya [To the question of the clinic, diagnosis and treatment of pityriasis versicolor]. Meditsinskiy zhurnal. 2015; 3(53):18-22.
- Kochergin NG, Tolchina LV. Eshchyo raz o raznotsvetnom lishae i malasseziyakh [Once again about pityriasis versicolor and malassezia]. Klinicheskaya dermatologiya i venerologiya. 2008; 4:115-9.
- Zaborova VA, Arzumanyan VG, Gurevich KG. Malassezios u sportsmenov [Malassezios in athletes]. Rossiyskiy zhurnal kozhnykh i venericheskikh bolezney. 2013;6:55-8.
- Zoirov PT, Abdulloeva MA, Kendzhaeva IO. Mikroflora i bakteritsidnye svoystva kozhi u bol’nykh raznotsvetnym lishayom [Microflora and bactericidal properties of the skin in patients with tinea versicolor]. Avicenna Bulletin (Vestnik Avitsenny). 2012;3:135-8.
- Rodoplu G. Distribution of Malassezia species in patients with Pityriasis versicolor in Turkey. J Micol Med. 2014;24(2):117-23.
- Kolontaya IYa, Anchupane IS, Miltinsh AP. Pityriasis versicolor u bol’nykh pervichnym gipergidrozom [Pityriasis versicolor in patients with primary hyperhidrosis]. Problemy meditsinskoy mikologii. 2010;12(2):100-1.
- Shi TW. A randomized controlled trial of combination treatment with ketokonazole 2% cream and adapalene 0,1% gel in Pityriasis versicolor. J Dermatolog Treat. 2015;26(2):143-6.
- Tamarro А. Atypical clinical manifestation of Pityriasis versicolor in a young boy. G Ital Dermatol Venereol. 2014;149(2):272-4.
- Sharma А. Clinicomycological profile of pityriasis versicolor in Assam. Indian J Pathol Microbiol. 2016;59(2):159-65.
- Congly H. Pityriasis versicolor in a 3-month-old boy. Can Med Assoc J. 2012;130(3):844-5.
- Day T. Vulvar pityriasis versicolor in an immunocompetent woman. J Low Genit Tract Dis. 2014;18(3):71-3.
Abdulloeva Muhabbat Ahmadalievna, Assistant of the Department of Dermatovenereology, Avicenna Tajik State Medical University
Zoirov Podabon Toshmatovich, Doctor of Medical Sciences, Full Professor, Corresponding Member of Academy of Sciences, Professor of the Department of Dermatovenereology, Avicenna Tajik State Medical University
Address for correspondence:
Abdulloeva Muhabbat Ahmadalievna
Assistant of the Department of Dermatovenereology Avicenna Tajik State Medical University
734003, Republic of Tajikistan, Dushanbe, Rudaki Avenue, 139
Tel.: (+992) 919 026698