Influência da corticoterapia sistêmica no desencadeamento da pitiríase versicolor

• Autor(a) principal: Fraga, Clarissa Matarangas Moreira da
• Data de Publicação: 2013
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
• Texto Completo: http://repositorio.ufes.br/handle/10/6480
• topic: Tinea versicolor; Corticosteroids; Oral administration; Risk factors; Tinha versicolor; Administração oral; Pitiríase versicolor; Pitiríase versicolor - Fatores de risco; Pityriasis versicolor; Malassezia; Medicina; Tinha (Doenças); Corticosteróides; Medicamentos - Administração; Fungos; Micoses; 61

Background: Pityriasis versicolor is a chronic superficial mycosis of great clinical importance due to its high prevalence and psychological impact on patients. The literature cites corticosteroid therapy as a risk factor for the emergence of fungal lesions, but the real relationship between mycosis and the use of corticosteroids is not fully established. Objective: To determine wether prolonged systemic corticosteroid therapy (minimum of thirdy days) is associated with an increased frequency of pityriasis versicolor. Patients and methods: This observational, transversal, analytical and comparative study was carried out from January 2012 to January 2013 in the Dermatology and Nephrology outpatient clinics of the Cassiano Antonio Moraes University Hospital (HUCAM), as well as in the leprosy clinic of the Maruipe primary health care unit in Vitoria (ES), where a hundred patients, using or not systemic corticosteroid therapy were interviewd and examined to identify the presence of pityriasis versicolor lesions. After clinical diagnosis, laboratory tests were performed to confirm the superficial mycosis.The data was analysed with the statistical program SPSS 17.0. Results: Out of the total a hundred patients, the mean age was 40 years old; nine cases of Pityriasis versicolor were identified, being eight from the corticosteroid therapy group and one not in use. As to the patients diagnosed with the mycosis, the predominant group age ranged from 20 to 39 years (66.7%), six were female (66.7%), seven were biracial (77.8%), eight were in prolonged systemic corticosteroid therapy, seven (77.8%) used low dose of systemic corticosteroid, four (57,1%) had leukocitosis, five (71,4%) had normal total cholesterol triglicerid serum levels and four (80%), normal glicemia. Discussion and conclusion: The study revealed an increased prevalence of pityriasis versicolor among patients using prolonged systemic corticosteroid therapy, when compared to the group with no use of corticosteroid, with statistically significant difference, confirming the results of the single study (1962) on this subject found in the medical literature. The mechanisms involved in the frequent development of pityriasis versicolor among systemic corticosteroid therapy users, wether by immunossupression or by impaired lipid metabolism, must be established in further studies, since data on blood glucose, lipid profile and WBC showed no statistical significance when compared to the group with no use of systemic corticosteroids.