PITIRIASIS VERSICOLOR
DEFINICIÓN:
Micosis superficial recurrente del estrato córneo, crónico de la piel, benigno,
cosmopolita, que predomina en zonas húmedas, tropicales y subtropicales.
ETIOLOGÍA:
•Malassezia Globosa (47.7%)(produce pigmentos a través de una enzima TAMI
(transaminasas 1).
•M.Furfur (36.4%)
-Son hongos levaduriformes que forman parte de la biota cutánea
FACTORES DE RIESGO:
•Humedad relativa- Altas temperaturas- Piel seborreica- Hiperhidrosis-
Tratamiento con corticoides sistémicos o con inmunosupresor- Malnutrición-
Acos orales- Exposición al sol- Ambiente húmedo- Uso de ropa oclusiva de alto
contenido en fibra sintética- Aplicación continua de lociones, ungüentos o
cremas en zonas de tendencia.
CLÍNICA:
•Placas lenticulares cubiertas con finas escamas furfuráceas de bordes
irregulares con tendencia a confluir.
•Cambio en la pigmentación (3 variantes clínicas):
★ Hipocromiante (La más frecuente)
★ Eritematosa (2do más frecuente)
★ Hipercromiante
•Seborrea
•Prurito
•Hiperhidrosis •Signo de la “Uñada”.
DIAGNÓSTICO:
•Luz de Wood (Se observa fluorescencia naranja o amarillo dorado).
•Prueba de cinta scotch
•Examen con KOH (Se observa en el microscopio esporas redondeadas entre
mallas de micelas que figuran “Spaghetti y Albóndigas").
TRATAMIENTO:
•Leve y localizado
➔ Ketoconazol shampoo 2% (1 ves al dia por 14 días)
➔ Flutrimazol Shampoo 1% (1 vez al día por 14 días)
➔ Terbinafina solución 1% (Aplicar 2 veces/día/1 semana)
➔ Clotrimazol crema 1% (Aplicar 2 veces/día/2 semanas).
•Lesión diseminada
➔ Ketoconazol 200 mg/dia/10 días
➔ Itraconazol 200 mg/dia/7 dias
➔ Fluconazol 400mg , dosis única (Ideal para recurrencias).
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