Background:Malassezia is a lipid-dependent yeast known to cause Pityriasis versicolor, a chronic, recurrent superficial infection of skin and present as hypopigmented or hyperpigmented lesions on areas of skin. If not diagnosed and treated, it may lead to disfigurement of the areas involved and also result in deep invasive infections.Aim:The aim of the present study was to identify and speciate Malassezia in patients clinically suspected of having Pityriasis versicolor.Materials and Methods:Total 139 patients suspected of having Pityriasis versicolor were evaluated clinically and diagnosis was done by Wood's lamp examination, confirmed mycologically by using KOH, cultivation on Sabouraud's dextrose agar and modified Dixon agar at a tertiary care hospital in Mumbai. The total duration of study was 12 months.Results:Majority of the patients were males (59.71%) in the age group of 21-30 years (33.81%) who were students (30.21%) by profession. The incidence of Malassezia in Pityriasis versicolor was 50.35%. The most common isolate was M. globosa (48.57%), followed by M. furfur (34.28%). Majority of the patients had hypopigmented lesions, with M. globosa as the predominant isolate. Neck was the most common site affected; 88.48% were Wood's lamp positive of which 56.91% of Malassezia isolates grew on culture. KOH mount was positive in 82.01% of which 61.40% Malassezia isolates grew on culture.Conclusions:The procedure of culture and antifungal testing is required to be performed as different species of Malassezia are involved in Pityriasis versicolor and susceptibility is different among different species. Thus, it would help to prevent recurrences and any systemic complications.
Background:Onychopathies constitute one of the major challenges faced by a dermatologist in terms of its early detection and diagnosis. Utility of dermoscope as a tool for detection is increasing by the day and its use in onychopathies needs to be explored.Aims:To study the dermoscopic features of nails in patients of chronic plaque psoriasis.Materials and Methods:In a cross-sectional study, a total of 68 patients with chronic plaque psoriasis were recruited. Dermoscopy of nail plate was conducted and were compared with equal number of age and sex matched healthy volunteers.Results:Forty-six patients showed dermoscopic findings. Twenty-two patients did not show any dermoscopic findings. Coarse pits (18/46, P < 0.0001), onycholysis (10/46, P < 0.001), oil drop sign (2/46, P = 0.12) and splinter hemorrhages (5/46, P = 0.05) were seen. In addition certain findings of interest were stout, globose, dilated, pink- to red-colored nail bed vessels arranged longitudinally at the onychodermal band surrounded by a prominent halo (9/46, P = 0.01). In contrast, splinter hemorrhages appeared as streaks and were purple in color.Conclusion:In a psoriasis patient, dermoscope can be a useful tool to detect early nail involvement in psoriasis and aid in differentiating it from other disorders of nails.
Head louse infestation, or pediculosis capitis, caused by Pediculus humanus var. capitis, is a common health concern in pediatric age group. An itching of the scalp is the chief symptom, whereas presence of viable nits confirms the diagnosis of head louse infestation. Secondary bacterial infection with impetignization with cervical and occipital lymphadenopathy can complicate the clinical scenario with physician misdiagnosing pediculosis to a primary bacterial infection. Screening and treatment of all close contacts is necessary for an adequate management of pediculosis. Medical management of head louse infestation requires proper application of topical pediculicidal agents', chiefly permethrin lotion and wet combing with a fine toothcomb. Severe cases with high parasitic load justify the use of either oral cotrimoxazole or Ivermectin. Other described technique involves a single application of hot air for 30 minutes. Radical but culturally unacceptable method would be shaving of scalp in resistant cases. Environmental fogging with insecticides is neither necessary nor recommended.
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