10.5826/dpc.1401a92
text/xml
2160-9381
3755
en
Gustavo Carvalho
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
UV Dermoscopy for the Diagnosis of Pityrosporum Folliculitis
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2024-01-31
2023-08-08
2024-01-31
2024-02-21
e2024092
Dermatol Pract Concept
Gustavo Carvalho
2024/01/31
10.5826/dpc.1401a92
e2024092
Preceptor of the dermatology clinic at the University of Santo Amaro - UNISA; Dermatologist at AC Camargo Cancer Center, São Paulo (SP), Brasil
2160-9381
en
e2024092
- Klatte JL, van der Beek N, Kemperman PM. 100 years of Wood's lamp revised. J Eur Acad Dermatol Venereol. 2015;29(5):842-7
UV Dermoscopy for the Diagnosis of Pityrosporum Folliculitis
https://dpcj.org/index.php/dpc/article/download/3755/2431
                        UV Dermoscopy for the Diagnosis
                           of Pityrosporum Folliculitis
                      Arthur Macedo Goulart Silva1, Alexandre Ozores Michalany2,3,
                                  Gustavo de Sá Menezes Carvalho2,4


1 Dermatology resident at the University of Santo Amaro - UNISA - São Paulo (SP), Brasil
2 Preceptor of the dermatology clinic at the University of Santo Amaro - UNISA - São Paulo (SP), Brasil
3 Pathologist at the dermatology clinic at the University of Santo Amaro - UNISA - São Paulo (SP), Brasil
4 Dermatologist at AC Camargo Cancer Center, São Paulo (SP), Brasil



Citation: Silva AMG, Michalany AO, Carvalho GSM. UV Dermoscopy for the Diagnosis of Pityrosporum Folliculitis. Dermatol Pract
Concept. 2024;14(1):e2024092. DOI: https://doi.org/10.5826/dpc.1401a92
Accepted: October 10, 2023; Published: January 2024
Copyright: ©2024 Silva et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing Interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding Author: Gustavo de Sá Menezes Carvalho, AC Camargo Cancer Center, 1167 Pires da Mota street, São Paulo /
State: São Paulo, Zip-Code: 01529-001. Tel: 11-2189-5000 Email: gustavo.carvalho@accamargo.org.br




Case Presentation                                                        has enzymes, such as lipases and phospholipases, capable of
                                                                         hydrolyzing triglycerides into fatty acids, thereby promot-
We present a case of a 17-year-old girl with a history of                ing follicular occlusion [1]. PF has a universal distribution,
disseminated erythematous follicular papules on the upper                predominantly affects young adults, and is associated with
chest, back, and upper limbs for the past 2 years, accompa-              antibiotic therapy, diabetes mellitus and immunosuppres-
nied by mild itching and intermittent periods of exacerbation            sants [1].
(Figure 1A). Upon examination, bright-green fluorescence                      With the advancement of new technologies, dermoscopy
was observed in the affected follicle using UV-induced flu-              combined with UV light has become an effective tool in the
orescence dermatoscopy (DL5, light 365nm, Dermlite®)                     investigation of such cases. In this case, the lesions presented
(Figure 1B). A biopsy of a follicular papule confirmed the               with follicle-bound bluish white, as previously described [2],
diagnosis of pityrosporum folliculits (PF) (Figure 1C). After            associated with the visualization of the central follicular
treatment with fluconazole 150 mg/week for 6 weeks, his                  bright green color only seen through the dermoscope with
lesions completely resolved.                                             UV light.
                                                                              We emphasize the importance of dermoscopy combined
Teaching Point                                                           with Wood lamp in the diagnostic elucidation of this condi-
                                                                         tion and encourage further scientific publications. The visu-
PF is a cutaneous condition secondary to infection of the hair           alization of this follicular staining can improve the diagnosis
follicle by fungi of the genus Malassezia spp [1]. This fungus           and treatment of these cases.




Image Letter | Dermatol Pract Concept. 2024;14(1):e2024092                                                                             1
Figure 1. (A) Diffuse follicular erythematous papules located on the trunk and upper limbs. (B) Bright-green fluorescence was observed in
the affected follicle and bound bluish white (DL5 with UV light, 10x). (C) Hair follicle whose lumen of the sebaceous duct is enlarged by
accumulation of secretion with focal parakeratosis and presence of spores (PAS, 400x).



References                                                                2023;315(6):1497-1509. DOI: 10.1007/s00403-022-02506-0.
                                                                          PMID: 36517586. PMCID: PMC9750048.
 1. Green M, Feschuk AM, Kashetsky N, Maibach HI. Clinical             2. Klatte JL, van der Beek N, Kemperman PM. 100 years of Wood’s
    characteristics and treatment outcomes of Pityrosporum fol-           lamp revised. J Eur Acad Dermatol Venereol. 2015;29(5):
    liculitis in immunocompetent patients. Arch Dermatol Res.              842-847. DOI: 10.1111/jdv.12860. PMID: 25428804.




2                                                                            Image Letter | Dermatol Pract Concept. 2024;14(1):e2024092
