Atrophying pityriasis versicolor as an idiosyncratic T cell–mediated response to Malassezia: A case series - 18/04/17
Abstract |
Background |
Atrophying pityriasis versicolor (PV), first described in 1971, is a rare variant in which lesions appear atrophic.
Objective |
We sought to determine the pathophysiology of atrophying PV.
Methods |
A retrospective chart review identified 6 cases of atrophying PV. In all cases, routine light microscopy, an elastic tissue stain, and immunohistochemical assessment for the expression of CD3, CD4, CD8, GATA3 and CXCR3 was performed.
Results |
All cases demonstrated hyperkeratosis with intracorneal infiltration by pathogenic hyphal forms as well as epidermal attenuation and papillary dermal elastolysis. A supervening, mild-to-moderate, superficial lymphocytic infiltrate was noted and characterized by a focal CD8+ T cell–mediated interface dermatitis along with a mixed T–cell infiltrate composed of GATA3+ and CXCR3+ T cells.
Limitations |
Small sample size and the loss of some patients to follow-up.
Conclusion |
Atrophying PV represents the sequelae of a mixed helper T–cell (TH1 and TH2) idiosyncratic immune response to Malassezia and can present as a protracted dermatosis that may clinically mimic an atypical lymphocytic infiltrate. TH1 cytokines can recruit histiocytes, a source of elastases, and upregulate matrix metalloproteinase activity, which may contribute to epidermal atrophy.
Le texte complet de cet article est disponible en PDF.Key words : pityriasis versicolor, atrophy, Malassezia, CD4, CD8, TH1, TH2, GATA3, CXCR3
Abbreviations used : MMP, PAS, PV, TH
Plan
Support for Jonathan Levy's elective rotation at Weill Cornell Medicine came from a Canadian Dermatology Foundation Kalz bursary. This research otherwise has no funding sources. |
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Conflicts of interest: None declared. |
Vol 76 - N° 4
P. 730-735 - avril 2017 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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