Marinello Elena, Piaserico Stefano, Alaibac Mauro
Unit of Dermatology, University of Padua, Padua, Italy.
BMJ Case Rep. 2017 Jan 18;2017:bcr2016218108. doi: 10.1136/bcr-2016-218108.
Pityriasis versicolor is one of the most frequent epidermal mycotic infections in the world, but its atrophic variant is rarely described. The aetiology of the atrophy is still unknown, and two main hypotheses have been formulated, one suggesting a correlation with long-term use of topical steroids and the other a delayed type hypersensitivity to epicutaneous antigens derived from components of the fungus. Atrophic pityriasis versicolor is a benign disease, but needs to be distinguished from other more severe skin diseases manifesting with cutaneous atrophy. The diagnosis can be easily confirmed by direct microscopic observation of the scales soaked in 15% potassium hydroxide, which reveals the typical 'spaghetti and meatball' appearance, or by a skin biopsy in doubtful cases. Here, we describe a case of extensive atrophic pityriasis versicolor occurring in a woman affected by Sjögren's syndrome which completely resolved after topical antifungal treatment.
花斑糠疹是世界上最常见的表皮真菌感染之一，但其萎缩型却鲜有报道。萎缩的病因尚不清楚，目前已提出两种主要假说，一种认为与长期外用糖皮质激素有关，另一种认为是对真菌成分衍生的表皮抗原的迟发型超敏反应。萎缩型花斑糠疹是一种良性疾病，但需要与其他表现为皮肤萎缩的更严重皮肤病相鉴别。通过直接显微镜观察浸泡在15%氢氧化钾中的鳞屑，可发现典型的“意大利面和肉丸”外观，从而轻松确诊，在诊断存疑的情况下也可进行皮肤活检。在此，我们报告1例发生在干燥综合征女性患者身上的广泛萎缩型花斑糠疹病例，经外用抗真菌治疗后完全缓解。
