Pityriasis amiantacea

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Pityriasis amiantacea
Other namesTinea amiantacea
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Specialty Dermatology   OOjs UI icon edit-ltr-progressive.svg

Pityriasis amiantacea is an eczematous condition of the scalp in which thick tenaciously adherent scale infiltrates and surrounds the base of a group of scalp hairs. It does not result in scarring or alopecia. [1] :647

Contents

Pityriasis amiantacea was first described by Alibert in 1832. [2] Pityriasis amiantacea affects the scalp as shiny asbestos-like (amiantaceus) thick scales attached in layers to the hair shaft. [3] The scales surround and bind down tufts of hair. [4] The condition can be localised or covering over the entire scalp. Temporary alopecia and scarring alopecia may occur due to repeated removal of hairs attached to the scale. It is a rare disease with a female predilection. [4]

Diagnosis

Pityriasis amiantacea can easily be misdiagnosed due to its close resemblance to other scalp diseases such as psoriasis, seborrhoeic dermatitis or lichen planus. However, in pityriasis amiantacea the scales are attached to both the hair shaft and the scalp. Pityriasis amiantacea may be present with other inflammatory conditions such as atopic dermatitis or seborrhoeic dermatitis and sebaceous scales and alopecia can occur. According to Bolognia's textbook "Dermatology," [5] this rare condition is most often combined with psoriasis, but it may also develop as secondarily infected atopic dermatitis, seborrheic dermatitis, and/or tinea capitis.

Treatment

The bacteria staphylococci are present in the majority of cases. [3] Treatment with systemic antibiotics and coal tar shampoo can completely clear the condition when Staphylococcus aureus bacteria are found. [4] Fungal infections such as tinea capitis are known to mimic the symptoms of the condition [6] and can be cleared with antifungal treatment.

See also

Related Research Articles

Hair loss loss of hair from the head or body

Hair loss, also known as alopecia or baldness, refers to a loss of hair from part of the head or body. Typically at least the head is involved. The severity of hair loss can vary from a small area to the entire body. Inflammation or scarring is not usually present. Hair loss in some people causes psychological distress.

Dandruff A skin condition mainly affecting the scalp causing flaking and itchiness

Dandruff is a skin condition that mainly affects the scalp. Symptoms include flaking and sometimes mild itchiness. It can result in social or self-esteem problems. A more severe form of the condition, which includes inflammation of the skin, is known as seborrhoeic dermatitis.

Tinea versicolor condition characterized by a rash on the trunk and proximal extremities

Tinea versicolor is a condition characterized by a skin eruption on the trunk and proximal extremities. The majority of tinea versicolor is caused by the fungus Malassezia globosa, although Malassezia furfur is responsible for a small number of cases. These yeasts are normally found on the human skin and become troublesome only under certain circumstances, such as a warm and humid environment, although the exact conditions that cause initiation of the disease process are poorly understood.

Folliculitis Human disease

Folliculitis is the infection and inflammation of one or more hair follicles. The condition may occur anywhere on the skin except the palms of the hands and soles of the feet. The rash may appear as pimples that come to white tips on the face, chest, back, arms, legs, buttocks, or head.

Seborrhoeic dermatitis long-term skin disorder

Seborrhoeic dermatitis, also known as seborrhoea, is a long-term skin disorder. Symptoms include red, scaly, greasy, itchy, and inflamed skin. Areas of the skin rich in oil-producing glands are often affected including the scalp, face, and chest. It can result in social or self-esteem problems. In babies, when the scalp is primarily involved, it is called cradle cap. Dandruff is a milder form of the condition.

<i>Malassezia</i> genus of fungi naturally found on skin surfaces of many animals including humans

Malassezia is a genus of fungi. Malassezia is naturally found on the skin surfaces of many animals, including humans. In occasional opportunistic infections, some species can cause hypopigmentation or hyperpigmentation on the trunk and other locations in humans. Allergy tests for this fungus are available.

Boil deep folliculitis, infection of the hair follicle

A boil, also called a furuncle, is a deep folliculitis, infection of the hair follicle. It is most commonly caused by infection by the bacterium Staphylococcus aureus, resulting in a painful swollen area on the skin caused by an accumulation of pus and dead tissue. Boils which are expanded are basically pus-filled nodules. Individual boils clustered together are called carbuncles. Most human infections are caused by coagulase-positive S. aureus strains, notable for the bacteria's ability to produce coagulase, an enzyme that can clot blood. Almost any organ system can be infected by S. aureus.

Dermatophytes are a common label for a group of three types of fungus that commonly causes skin disease in animals and humans. These anamorphic mold genera are: Microsporum, Epidermophyton and Trichophyton. There are about 40 species in these three genera. Species capable of reproducing sexually belong in the teleomorphic genus Arthroderma, of the Ascomycota.

Tinea capitis Human disease

Tinea capitis is a cutaneous fungal infection (dermatophytosis) of the scalp. The disease is primarily caused by dermatophytes in the genera Trichophyton and Microsporum that invade the hair shaft. The clinical presentation is typically single or multiple patches of hair loss, sometimes with a 'black dot' pattern, that may be accompanied by inflammation, scaling, pustules, and itching. Uncommon in adults, tinea capitis is predominantly seen in pre-pubertal children, more often boys than girls.

Cradle cap Human disease

Cradle cap causes crusty or oily scaly patches on a baby's scalp. The condition isn't painful or itchy. But it can cause thick white or yellow scales that aren't easy to remove. Cradle cap most commonly begins sometime in the first three months but can occur in later years. Similar symptoms in older children are more likely to be dandruff than cradle cap. The rash is often prominent around the ear, the eyebrows or the eyelids. It may appear in other locations as well, where it is called seborrhoeic dermatitis rather than cradle cap. The exact cause of cradle cap is not known. Doctors think the condition is due to oil glands in the baby's scalp producing too much oil. Cradle cap is not spread from person to person (contagious). It is also not caused by poor hygiene. It is not an allergy, and it is not dangerous. Cradle cap often lasts a few months. In some children, the condition can last until age 2 or 3.

Dermatophytosis Fungal infection of the skin

Dermatophytosis, also known as ringworm, is a fungal infection of the skin. Typically it results in a red, itchy, scaly, circular rash. Hair loss may occur in the area affected. Symptoms begin four to fourteen days after exposure. Multiple areas can be affected at a given time.

Erythroderma Inflammatory skin disease with redness and scaling

Erythroderma is an inflammatory skin disease with redness and scaling that affects nearly the entire cutaneous surface. This term applies when 90% or more of the skin is affected.

This is a shortened version of the twelfth chapter of the ICD-10: Diseases of the skin and subcutaneous tissue. It covers ICD codes L00 to L99. All versions of the ICD-10, including the most recent one (2019), can be browsed freely on the website of the World Health Organisation (WHO). The ICD-10 can also be downloaded in PDF-form.

<i>Malassezia furfur</i> Species of fungus that is naturally found on the skin surfaces of humans and is associated with seborrhoeic dermatiti

Malassezia furfur is a species of fungus that is naturally found on the skin surfaces of humans and some other mammals. It is associated with a variety of dermatological conditions caused by fungal infections, notably seborrhoeic dermatitis and tinea versicolor. As an opportunistic pathogen, it has further been associated with dandruff, pityriasis versicolor, and tinea circinata, as well as catheter-related fungemia and pneumonia in patients receiving hematopoietic transplants. The fungus can also affect other animals, including dogs.

Trachyonychia, is a condition characterized by rough accentuated linear ridges on the nails of the fingers and toes. When the condition occurs on all the twenty nails of the fingers and toes, it is known as twenty-nail dystrophy, most evident in childhood, favoring males.

Madarosis is a condition that results in the loss of eyelashes, and sometimes eyebrows. The term "madarosis" is Greek for the word "madao" which means "to fall off." It originally was a disease of only losing eyelashes but it currently is the loss of both eyelashes and eyebrows. Eyebrows and eyelashes are both important in the prevention of bacteria and other foreign objects from entering the eye. A majority of patients with madarosis have leprosy, and it was reported that 76% of patients with varying types of leprosy had madarosis.

<i>Microsporum audouinii</i> species of fungus

Microsporum audouinii is an anthropophilic fungus in the genus Microsporum. It is a type of dermatophyte that colonizes keratinized tissues causing infection. The fungus is characterized by its spindle-shaped macroconidia, clavate microconidia as well as its pitted or spiny external walls.

Folliculitis decalvans

Folliculitis decalvans is an inflammation of the hair follicle that leads to bogginess or induration of involved parts of the scalp along with pustules, erosions, crusts, ulcers, and scale. It begins at a central point and spreads outward, leaving scarring, sores, and, due to the inflammation, hair loss in its wake. No permanent cure has been found for this condition, but there is promise in a regimen of dual therapy with rifampin 300 mg twice daily and clindamycin 300 mg twice daily. This new treatment can be used to control the condition, and tests have indicated that after 3 to 5 months long uninterrupted courses of treatment, many patients have seen limited to no recurrence.

References

  1. Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN   0-07-138076-0.
  2. Alibert JL. La porrigine amiantacea. Monographie des Dermatoses. Paris, France, 1832: 293-5.
  3. 1 2 Abdel-Hamid IA, Salah AA, Moustafa YM, El-Labban AM. Pityriasis amiantacea: a clinical and etiopathologic study of 85 patients. Int J Dermatol 2003; 42: 260-4.
  4. 1 2 3 Raquel M. Shalev, Arnon D. Cohen, Evgeny Medvedovsky, Stella Sashavinsky, Theodore Tchetov and Daniel A. Vardy. Pityriasis Amiantacea Associated with Staphylococcus aureus Super-infection in Bedouin Patients. Microbial Ecology in Health and Disease 2004; 16: 218-221
  5. Bolognia et al. Dermatology, Second Edition, pg 122
  6. M. Ginarte, M. Pereiro Jr, Virginia Ferna´ndez-Redondo and Jaime Toribio Case Reports. Pityriasis amiantacea as manifestation of tinea capitis due to Microsporum canis. mycoses 2000, 43, 93–96
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