Pityriasis

Oral treatment offers the advantage of bringing all the lesions at all sites under control, in addition to the absence of unpleasant cosmetic effects. In certain cases, it may be preferable to use oral treatment for C. albicans vaginitis and for extensive and persistent pityriasis versicolor, a skin disorder caused by Pityrosporum orbiculare. In the case of onychomycosis, a combination treatment, topical plus systemic, is required. It is preferable to use oral treatment for deep and systemic mycoses, though intravenous or intrathecal treatment is sometimes required. 

Acitretine ch3o x x Oral 0.25-1.0 mg/kg/d Psoriasis (erythrodermic, pustular, and severe recalcitrant) Palmoplantar keratoderma pustulosis palmoplantaris, icthyosis, Darier s disease, pityriasis rubra pilaris, lichen ruber planus... 

Exfoliative dermatitis Widespread dermatitis characterized by scaling and shedding of the skin and usually accompanied by redness. Also called pityriasis rubra. 

Miconazole is an imidazole antifungal agent used as miconazole base or miconazole nitrate for the treatment of superficial candidiasis and of skin infections dermato-phytosis and pityriasis versicolor. The drug has also been given intravenously by infusion for the treatment of disseminated fungal infections. Miconazole can be given by mouth in a dose of 120-240 mg, as oral gel four times daily after food, for... 

Selenium sulflde is a complementary drug for use in rare disorders or in exceptional circumstances. It has activity in pityriasis versicolor (lotion) and in se-borrhoeic dermatitis. Adverse effects include local irritation and hair discoloration or loss. Absorption may result in systemic toxicity including tremors, weakness, lethargy, pain in lower abdomen and occasional vomiting. 

Selenium sulfide is a cytostatic and sporicidal agent available without prescription in a variety of shampoos and lotions for treatment of scalp seborrheic dermatitis. Higher concentrations are available by prescription for the treatment of pityriasis versicolor, which is caused by the yeast M. furfur, and tinea capitis. 

It is indicated in vulvovaginal candidiasis. Trichomonas vaginitis, otomycosis, tinea and Pityriasis versicolor. 

Terbinafine is used in the treatment of dermatophytoses especially onchomycosis by oral therapy. Also useful in tinea and pityriasis versicolor. 

Topical and shampoo forms of ketoconazole are also available and useful in the treatment of seborrheic dermatitis and pityriasis versicolor. Several other azoles are available for topical use (see Preparations Available). 

Propylene glycol is used under polyethylene occlusion or with 6% salicylic acid for the treatment of ichthyosis, palmar and plantar keratodermas, psoriasis, pityriasis rubra pilaris, keratosis pilaris, and hypertrophic lichen planus. 

In one case, pityriasis lichenoides disappeared after withdrawal of oral contraceptives (245). 

Arrese, J.E., Pierard-Franchimont, C., De Doncker, P., Heremans, A., Cauwenbergh, G., and Pierard, G.E. Effect of ketoconazole-medicated shampoo on squamometry and Malassezia ovalis load in pityriasis capitis. Cutis 58, 235-237 (1996). 

A 19-year-old patient taking lithium therapy for bipolar I disorder developed a pityriasis rosea-like dermatitis, which resolved when valproic acid was substituted for lithium (403). The rash was defined as erythematous, sharply bordered oval and finely scaling lesions along skin cleavages on the trunk and proximal parts of the extremities. There was no evidence of a herald patch. 

There have been anecdotal reports of papular and non-papular rashes, pityriasis versicolor, hidradenitis suppurativa, and nail dystrophy (405,406), although causal relations are difficult to establish. 

Senol M, Ozcan A, Ozcan EM, Aydin EN. Pityriasis rosea-like eruption due to lithium. Clin Drug Invest 2004 24 493-4. 

Martin AG, Kobayashi GS Yeast infections Candidiasis, pityriasis (tinea) versicolor in Fitzpatrick TB, Eisen AZ, Wolff K, Freedberg IM, Austen KF (eds) Dermatology in General Medicine, ed 4. New York, McGraw-Hill, 1993, pp 2421-2451. 

Faergemann J Pityriasis versicolor Current treatments in Aly R, Beutner KR, Maibach H (eds) Cutaneous infection and therapy. New York, Dekker, 1997, pp 211—215. 

Miconazole is an alternative. Clotrimazole is an effective topical agent for dermatophyte, yeast, and other fungal infections (intertrigo, athlete s foot, ringworm, pityriasis versicolor, fungal nappy rash). 

Griseofulvin is effective against all superficial ringworm (dermatophyte) infections but is ineffective against pityriasis versicolor, superficial candidiasis and all systemic mycoses. 

Pityriasis rosea Antipruritics and emollients as appropriate The disease is self-limiting... 

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