Steroid acne vs. Pityrosporum folliculitis: the incidence of Pityrosporum ovale and the effect of antifungal drugs in steroid acne.
BACKGROUND
Steroid acne is a folliculitis that can result from systemic or topical administration of steroid, and has been described as showing a similar clinical picture to Pityrosporum folliculitis, but there have been few reports about the incidence of Pityrosporum ovale and the effect of antimycotic drugs in steroid acne and other acneiform eruptions. Our purpose was to describe the association between steroid acne and P. ovale, and to confirm the superior efficacy of oral antifungal drugs over anti-acne drugs in the treatment of steroid acne.


METHODS
The history, clinical features direct microscopy, histopathologic analysis, and therapeutic results of 125 cases with steroid acne or other acneiform eruptions were described and compared.


RESULTS
Over 80% of patients with acneiform eruption receiving systemic steroid revealed significant numbers of P. ovale in the lesional follicle. Furthermore, oral antifungal drug (itraconazole) showed significantly better clinical and mycologic effects than any other group of medications used in this study.


CONCLUSIONS
Steroid acne and other acneiform eruptions showing discrete follicular papules and/or pustules localized to the upper trunk and acneiform facial skin lesions associated with multiple acneiform lesions on the body in the summer period should be suspected as Pityrosporum folliculitis. In addition, oral antifungal drugs recommended for Pityrosporum folliculitis; however, it will require a larger case-control study to confirm the superiority of antifungal therapy over anti-acne treatment.
Yu
H J
HJ
Department of Dermatology, College of Medicine, Hanyang University, South Korea.
Lee
S K
SK
Son
S J
SJ
Kim
Y S
YS
Yang
H Y
HY
Kim
J H
JH
D000152:Acne Vulgaris / Q000188:drug therapy / Q000473:pathology*; D017486:Acneiform Eruptions / Q000188:drug therapy / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D003881:Dermatomycoses / Q000188:drug therapy* / Q000453:epidemiology; D003937:Diagnosis, Differential; D005260:Female; D005499:Folliculitis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D018859:Hair Follicle / Q000382:microbiology / Q000473:pathology; D006801:Humans; D015994:Incidence; D017964:Itraconazole / Q000627:therapeutic use; D007723:Korea / Q000453:epidemiology; D008290:Malassezia / Q000187:drug effects*; D008297:Male; D008825:Miconazole / Q000031:analogs & derivatives / Q000627:therapeutic use; D008853:Microscopy; D008875:Middle Aged; D008911:Minocycline / Q000627:therapeutic use; D012867:Skin / Q000187:drug effects / Q000382:microbiology / Q000473:pathology; D013170:Spores / Q000187:drug effects; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D017964:Itraconazole; D008825:Miconazole; D008911:Minocycline; C020382:isoconazole