Ann Dermatol.  2012 Aug;24(3):345-347. 10.5021/ad.2012.24.3.345.

Pityriasis Versicolor on Penile Shaft in a Renal Transplant Recipient

• Ryu HW
• Cho JW
• Lee KS

• KMID: 2265309
• DOI: http://doi.org/10.5021/ad.2012.24.3.345

Abstract

Pityriasis versicolor is a superficial infection of the stratum corneum, which is caused by the Malassezia species. Tge Malassezia species consist of 12 subspecies, including M. furfur, M. pachydermatis, M. symphodialis and M. globasa. The Malassezia species are classified as a normal flora, particularly in the sebum rich areas of the skin, and they convert from saprophytic yeast to parasitic mycelial morpholgic form to cause clinical disease. But majorities of their distributions are in the upper back, the neck, the thighs, and the forearm, and not in the penis. It is well known that the renal transplant patients, who take immunosuppressive agents, have impairment in the protective cell mediated immunity. Thus, they are more susceptible to infectious diseases, such as a fungal infection. Therefore, clinical manifestations show higher incidence of disease, but they mostly occur in an expected distribution. We here report a case of pityriasis versicolor in a renal transplant recipient on penile shaft, which is an unusual area.

Keyword

Immunocompromised patient; Penis; Tinea versicolor

MeSH Terms

Communicable Diseases
Forearm
Humans
Immunity, Cellular
Immunocompromised Host
Immunosuppressive Agents
Incidence
Malassezia
Male
Neck
Penis
Pityriasis
Sebum
Skin
Thigh
Tinea Versicolor
Transplants
Yeasts
Immunosuppressive Agents

Figure

• 

  Fig. 1 Several hypopigmented scaly macules on circumcised penile shaft.

• 

  Fig. 2 Clusters of yeast and short mycelia filaments that typical finding as spaghetti and meatball appearance on scale in a KOH preparation (×100).

Reference

1. Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ. Fitzpatrick's dermatology in general medicine. 2008. 7th ed. New York: McGraw-Hill;1822–1830.

2. Saadatzadeh MR, Ashbee HR, Cunliffe WJ, Ingham E. Cell-mediated immunity to the mycelial phase of Malassezia spp. in patients with pityriasis versicolor and controls. Br J Dermatol. 2001. 144:77–84.

3. Smith EL. Pityriasis versicolor of the penis. Br J Vener Dis. 1978. 54:441.

4. Blumenthal HL. Tinea versicolor of penis. Arch Dermatol. 1971. 103:461–462.

5. Nia AK, Smith EL. Pityriasis versicolor of the glans penis. Br J Vener Dis. 1979. 55:230.

6. Khaddar RK, Cherif F, Ben Hadid R, Mokni M, Ben Osman A. Penile shaft involvement in pityriasis versicolor. Acta Dermatovenerol Alp Panonica Adriat. 2008. 17:86–89.

7. Güleç AT, Demirbilek M, Seçkin D, Can F, Saray Y, Sarifakioglu E, et al. Superficial fungal infections in 102 renal transplant recipients: a case-control study. J Am Acad Dermatol. 2003. 49:187–192.

8. Shuttleworth D, Philpot CM, Salaman JR. Cutaneous fungal infection following renal transplantation: a case control study. Br J Dermatol. 1987. 117:585–590.

9. Aridoğan IA, Ilkit M, Izol V, Ates A. Malassezia and Candida colonisation on glans penis of circumcised men. Mycoses. 2005. 48:352–356.

10. Ashbee HR. Update on the genus Malassezia. Med Mycol. 2007. 45:287–303.

11. Boardman CR, Malkinson FD. Tinea versicolor in steroid-treated patients. Incidence in patients with chronic ulcerative colitis and regional enteritis treated with corticotropin and corticosteroids. Arch Dermatol. 1962. 85:44–52.

12. Sugita T, Tajima M, Ito T, Saito M, Tsuboi R, Nishikawa A. Antifungal activities of tacrolimus and azole agents against the eleven currently accepted Malassezia species. J Clin Microbiol. 2005. 43:2824–2829.

13. Meier-Kriesche HU, Friedman G, Jacobs M, Mulgaonkar S, Vaghela M, Kaplan B. Infectious complications in geriatric renal transplant patients: comparison of two immunosuppressive protocols. Transplantation. 1999. 68:1496–1502.