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Pityrosporum ovale and skin diseases
1Department of Dermatology, University of Gothenburg, Sahlgren's Hospital, Sweden.
Abstract:
Pityrosporum ovale is a lipophilic yeast belonging to the normal human cutaneous flora in adults. It is not only a saprophyte but also an opportunistic pathogen associated with: Pityriasis versicolor, Pityrosporum folliculitis, seborrhoeic dermatitis and some forms of atopic dermatitis. Even systemic infections have been described. In pityriasis versicolor P. ovale change from the blastospore to the mycelial form under the influence of predisposing factors such as high temperature, high relative humidity or endogenous factors such as greasy skin, sweating, heredity, immunosuppressive treatment or disorders. Topical treatment is often effective but short term treatment with fluconazole, ketoconazole or itraconazole is also effective. The great problem is recurrence and to avoid this a prophylactic treatment is mandatory. Pityrosporum folliculitis is a chronic disease characterized by pruritic follicular papules and pustules located primarily on the upper trunk, neck and upper arms. Under the influence of the same predisposing factors as in pityriasis versicolor P. ovale increase in numbers in the hair follicles. The main differential diagnosis is acne vulgaris. The effect of antifungal treatment is often dramatic. There are now many studies indicating that P. ovale plays an important role in seborrhoeic dermatitis. Many of these are treatment studies showing a good effect of antimycotics parallelled by a reduction in number of P. ovale. Severe seborrhoeic dermatitis often difficult to treat is associated with AIDS. In a recent study we have evidence for a slight T-cell defect in many patients with seborrhoeic dermatitis.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
Pityrosporum ovale, a common skin yeast, can cause infections like pityriasis versicolor and seborrheic dermatitis. Antifungal treatments are effective, but recurrence is common, necessitating prophylactic measures.
Area of Science:
- Dermatology
- Mycology
- Human Cutaneous Flora
Background:
- Pityrosporum ovale is a lipophilic yeast part of normal adult skin flora.
- It acts as an opportunistic pathogen linked to various skin conditions including pityriasis versicolor, folliculitis, and seborrheic dermatitis.
- Systemic infections caused by P. ovale have also been documented.
Purpose of the Study:
- To review the role of Pityrosporum ovale as an opportunistic pathogen.
- To discuss predisposing factors, clinical manifestations, and treatment strategies for P. ovale-associated dermatoses.
- To highlight the challenges in managing recurrent infections and the importance of prophylaxis.
Main Methods:
- Literature review of Pityrosporum ovale's role in dermatological conditions.
- Analysis of predisposing factors contributing to P. ovale overgrowth and pathogenicity.
- Evaluation of current therapeutic approaches, including topical and systemic antifungals.
Main Results:
- P. ovale transitions from blastospore to mycelial forms under specific environmental and host factors, leading to infections.
- Effective treatments include topical and short-term oral antifungals (fluconazole, ketoconazole, itraconazole).
- Recurrence is a significant issue, underscoring the need for prophylactic treatment strategies.
Conclusions:
- Pityrosporum ovale is a key player in several common and some severe dermatological conditions.
- Effective management requires addressing predisposing factors and employing appropriate antifungal therapy, often with a focus on prophylaxis to prevent recurrence.
- Further research may explore underlying host factors, such as T-cell defects, in severe or recurrent cases.