Pityrosporum folliculitis in the Philippines: diagnosis, prevalence, and management.

Sixty-eight typical cases were studied to define the course of Pityrosporum folliculitis in a tropical setting. Contrary to reports in the literature, we found Pityrosporum folliculitis to be polymorphic. The "molluscoid" comedopapule was the most characteristic and common lesion, and it yielded consistently high spore counts. The face was commonly involved. To establish the diagnosis, we used direct microscopy of potassium hydroxide/Parker blue-black ink mounts of the lower poles of comedonal plugs. Pityrosporum folliculitis is common in the Philippines, although our adult controls had a low incidence of skin carriage of Pityrosporum orbiculare on the face compared with those reported in the West. Pityrosporum folliculitis coexisted with acne vulgaris in 56% of patients, and the addition of antimycotics to the acne regimen produced dramatic clearing of lesions.