Table 2.
Detailed description of PF studies (n = 15)
| Study characteristics | Patient characteristics | PF information | Treatment and outcomes | Other variables | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Author, year | Study type | Sample size | Age, mean | Sex (majority) | PF diagnosis method | Location | Symptoms | Concomitant AV | Prior failed treatments | Treatment | Treatment outcome | Other variables noted |
| Prindaville et al. (2018) | Retrospective cohort | 110 | 15 | F: n = 76/110, 69% | KOH test (n = 110/110) | Forehead (n = 81/110, 74%), upper back (n = 80/110, 73%) | Pruritus (n = 72/110, 65%) | NR | Previously treated for AV with antibiotics (approximately 75%) | Oral antifungals (n = 26/110); topical antifungals (n = 60/110) |
Oral antifungals: improvement or complete response (n = 25/26, 96%); topical antifungals: improvement or complete response (n = 60/60, 100%) |
NR |
| Levy et al. (2007) | Retrospective cohort | 26 | 46 | M: n = 22/26, 85% |
Microscopy or histology (n = 26/26) |
NR | NR | NR | Previously treated for AV (approximately 65%) | Oral ketoconazole; combination oral and topical ketoconazole (n = NR) | Complete response in approximately 75% of cases | NR |
| Purnak et al. (2018) | Prospective cohort | 55 | 23 | F: n = 42/55, 76% | Tzanck smear (n = 55/55) | Most commonly forehead, cheeks, and trunk | Pruritus (n = 39/55, 71%) | NR | Previously treated for AV (n = 28/38, 74%) | Oral itraconazole and ketoconazole cream (n = 38/55) | 50% or more reduction in lesions (n = 26/38, 68%) | Season: PF was significantly more common in the summer compared to the winter (n = 34/55 vs. n = 21/55, p = 0.001) |
| Yu et al. (1998) | Retrospective cohort | 75 | NR | NR | Twenty-six of 34 (76.5%) patients diagnosed with steroid acne tested positive for Pityrosporum ovale spores in the hair follicles; 19/21 (90.5%) patients diagnosed with PF tested positive for spores, and 3/20 (15%) patients diagnosed with AV tested positive for spores | NR | NR | NR | NR | Oral itraconazole (n = 29/75); oral minocycline (n = 8/75), and isoconazole nitrate or resorcinol/salicylic acid solution (n = 11/75) | Improvement in n = 27/29 (93.1%) with oral itraconazole, n = 4/8 (50%) with oral minocycline, n = 5/11 (46%) with topical isoconazole nitrate or resorcinol/salicylic acid solution | NR |
| Ran et al. (1988) | NR | 7 | 27 | M: n = 6/7, 86% | Histopathology (n = 7/7) | Back (n = 7/7, 100%), chest (n = 6/7, 85.7%) | Pruritus (n = 7/7, 100%) | AV at the time of presentation (n = 4/7, 57%) | NR | NR | NR | No history of steroid or antibiotic use (n = 7/7) |
| Ayers, Sweeney and Wiss (2005) | NR | 6 | NR | F: n = 6/6, 100% | KOH test (n = 6/6) | Most commonly face, forehead and cheeks (n = 5/6, 83.3%) or shoulders and back (n = 4/6, 66.7%) | Pruritus (n = 6/6, 100%) | Concurrent AV (n = 6/6, 100%) | Previously treated for AV with oral antibiotics (n = 5/6, 83.3%) | Oral and topical antifungal combination regimens | Improvement (n = 6/6, 100%) | NR |
| Tsai et al. (2018) | Retrospective cohort | 94 | NR | NR | Histological and periodic acid-Schiff stain (n = 94/94) | Most commonly face and scalp (n = 11/22, 50%), legs (n = 4/22, 18.2%) | NR | NR | NR | NR | NR | Morphology: typical (n = 72/94, 77%) with characteristic papules and pustules, or atypical (n = 22/94, 23%) with significantly less papules, and having atypical macules/patches, and plaques |
| Tsai et al. (2019) | Retrospective cohort | 321 |
Pediatric n = 79/321, 25% Adult: n = 242/321, 75% |
M: n = 57/79, 72.2% | Microscopy or biopsy (n = 321/321) | Most commonly chest (n = 59/79, 74.7% pediatrics; n = 177/242, 73% adults), face (n = 17/79, 22% pediatric; n = 28/242, 12% adults, p = 0.027) | Pruritus (n = 24/79, 30.4% pediatrics; n = 93/242, 38% adults) | NR | History of antibiotic use (n = 17/79, 21.5% pediatrics; n = 60/242, 24.8% adults) |
Pediatric: oral antifungals (n = 60/79, 76%); topical antifungals (n = 19/79, 24%) Adult: oral antifungals (n = 157/242, 65%); topical antifungals (n = 85/242, 35%) |
Pediatric: improvement in n = 41/47 (87%) with oral antifungals; n = 9/9, 100%) with topical antifungals Improvement in n = 119/126 (94%) with oral antifungals and in n = 34/42 (81%) with topical antifungals |
Season: most commonly during summer months (n = 34/79, 43% pediatrics, n = 98/242, 40.5% adults) Effectiveness of direct microscopy with KOH versus histology for PF diagnosis: direct microscopy increased the annual diagnosis of PF |
| Danby (2016) | NR | 151 | NR | NR | Clinically (n = 151/151) | NR | NR | NR | Oral antibiotics or steroids prior to PF presentation (51%) | Oral ketoconazole | Only 12 patients showed no change in the number of lesions after the eight-week treatment, with greater than half showing complete resolution or significant improvement | NR |
| Suzuki et al. (2016) | NR | 44 | 36 | M: n = 35/44, 80% | Methylene blue stain (n = 36/36) | Chest in approximately 60% of patients | Pruritus in approximately 80% of patients | NR | No antibiotic use was reported in any patients, but 8/44 (18.2%) patients reported recent topical steroid use | 2% ketoconazole cream (n = 37/44, 84%), oral itraconazole (n = 7/44, 16%) | Improvement in n = 37/37 (100%) with 2% ketoconazole cream, and in n = 7/7 (100%) with oral itraconazole | NR |
| Parsad, Saini, and Negi (1998) | Double-blind study | 26 | NR | M: n = 16/26, 62% | KOH test (n = 26/26) | NR | NR | NR | NR |
Itraconazole (n = 13/26), placebo 9n = 12/26) |
Complete response in n = 9/13 (69%) and no response in n = 1/13 (8%) with itracanazole. No response or worsening in n = 8/12 (67%) or marked response in n = 1/12 (8%) with placebo | NR |
| Lim, Giam and Tan (1987) | Retrospective cohort | 48 | 22 | M: n = 44/48, 92% | Histology or gram-stain (n = 48/48) | NR | Pruritus (n = 37/48, 77%) | Concurrent AV (n = 9/48, 19%) |
Antibiotic therapy (n = 43/48, 89.6%) Additionally, some patients PF was preceded by antibiotic or corticosteroid use (n = 8/48, 16/7%, n = 1/48, 2.1%) |
NR | NR |
Aggravating factors for PF: n = 34/48 (71%) cited heat and sweating as an aggravating factor Common concomitant diagnoses: seborrhea (n = 48/48, 100%), seborrheic dermatitis (n = 18/48, 38%) |
| Yong, Tan and Tan (2021) | Cohort | 214 | NR | M: n = 162/214, 76% | Gram-stain (n = 214/214) | Most commonly back (n = 137/214, 64%), chest and trunk (n = 123/214, 57.5%) | NR | NR | NR | Oral antifungals (n = 128/214, 60%); or topical antifungals (n = 82/214, 38%) | Complete response in n = 118/128 (92%) with oral antifungals and (n = 66/82, 81%) with topical antifungals | NR |
| Back, Faergemann, and Hornqvist (1985) | NR | 51 | 30 (median) | F: n = 39/51, 77% | Cellophane stripping stained with methylene blue or KOH (n = 51/51) | NR | NR | Concurrent AV (n = 3/51, 6%) | Misdiagnosed and unsuccessfully treated (n = 20/ 51, 39%) | Selenium sulfide shampoo (n = 22/25, 88%), propylene glycol 50% in water (n = 12/12, 100%), or econazole cream (n = 8/10, 80%) | NR | Common concomitant diagnoses: seborrheic dermatitis (n = 9/51, 18%), pityriasis versicolor (n = 8/51, 16%) |
| Abdel-Razek et al. (1995) | Clinical trial | 62 | 22 | F: n = 40/62, 64% | NR | Most commonly trunk (n = 59/62, 95.2%) | Pruritus (n = 59/62, 95%) | Concurrent AV (n = 8/62, 13%), | NR | Oral ketoconazole and topical 2% ketoconazole (n = 20/62), oral ketoconazole (n = 20/62), econazole nitrate 1% solution (n = 12/62), and miconazole nitrate 2% cream (n = 10/62) | Complete response in 100% (n = 20/20) with oral ketoconazole and topical 2% ketoconazole; 75% (n = 15/20) with oral ketoconazole, 0% with econazole nitrate 1% solution and miconazole nitrate 2% cream | Common concomitant diagnoses: tinea versicolor (n = 6/62, 10%) and seborrhea (n = 5/62, 8%) |