397

PITYRIASIS VERSICOLOR IN CHILDREN.

R. MICHALOWSKI AND H , R O D Z I E W I C Z .
De^natoIogi(^al Depai tmont. Medical School. Dyniitrowa 11 Lublin, Poland,
(Head : Prof. R. Michalowski.)

IN temperate climates, pityriasis versieolor chiefly affects adolescents and

adults between the Jiges of fifteen and forty years. Textbooks of dermatology
state that it is rare in children, but statistical data are lacking.
We therefore undertook a study of 305 children from the town of Lublin,
154 boys and 151 girls between the ages of 4 months and 10 years. They were
examined in daylight and also under Wood's light because it is well known
that in adults the lesions of this disease liuoresce a yellowish-green. In all
eases, scrapings were taken from affected areas and examined in 20 % sodium
hydroxide.
CLINICAL PICTUBE.
Examination under Wood's light was invaluable in revealing pityriasis
versicolor in ehildren for tho patches were often invisible by daylight. Under
Wood's Ught they showed as distinet dark brown patches J-l em. in diameter,
of in-egular shape and confluent to form large areas. The boundaries were

Fic. 1.
398 R. MICHALOWSKI AND H. RODZIEWICZ

indefinite and the surface always smooth but it became covered with tiny
scales when scratched. If visible by daylight the patches were somewhat
darker than the surrounding skin. The most frequent localization was over
the sternum and above the nipples, in the anterior axillary region and between
the scajiulae (Fig. 1) Some ofthe cliildren showed itierease<l perspiration and
almost all of them had moist skins through being too warmly clad. Malassezia
furfur was most often seen in scrapings from the presternal area, followed by
tho axillae and interscapular area. Spores and mycelium were seen : filaments
l)redominated and were short and erescentic : spores were rare, small, round

FIG. 2.

and clustered (Fig. 2), In some cases, filaments twice or thrice as long as in adults
were Been. In one instance, in a ehild of 3 years, some spherical spores showed
buds on the surface.

RESULTS.
Table I shows the incidence of pityriasis versicolor accordiiig to age.
Among 2fl children under 1 year of age, the disorder was found in 2, a girl
aged II months and a hay aged 12 months. Dividing the ehildren into four
groups, 6-9 % between infancy and 1 year, 0-3 % between 1 and 3 years, 10-5 %
between 4 and 7 years and 23-5% between 8 and 10 years were affected. It
was commoner in girls (13-8%) than in boys (7-7%).
 PITYRIASIS VERSICOLOR IN CHILDREN 399

TABLE Distribution oj Cases oj rit]i/rias•IS V erincotcyi

Age (years).
1 2 3 4 5 r. 7 8 9 10 Total.
Boy.s examined 16 4 11 9 21 10 74 4 2 3 . 154
afFected I 0 1 2 2 0 5 1 0 0 12

[jirls examined 13 7 10 11 17 5 80 8 2 . 151

affected I 1 1 1 0 1 13 2 I 21

Total examined . 29 11 21 20 38 15 10 2 f, . 305

„ affected 2 I 2 3 2 I 18 3 I) 1 33

DISCUSSION.

The examination of these children showed that pityriasis versicolor was not
rare in children. In our series of 305, it occurred in 33 cases, or 10-8 %. This
large number of cases could only be diagnosed with the help of Wood's light,
for the patches were usually invisible by daylight. In some eases the patches
of pityriasis versicolor could be seen by daylight and appeared as irregularly
shaped areas with indefinite bomidaries. slightly darker than the surrounding
ykin with none of the features of the disease as found in adults and therefore
easy to overlook.
In the available literature we found no reports of pityriasis versicolor in
ehildren in a temp(!rate climate between 1 month and 10 years of age. There
are a number of reports of observations made in the tropics where this infection
is very frequent in children (Gyorko, 1951 ; Vanbreuseghem, 1950 ; Jacobson
and Jelliffe, 1055). Vanbreuseghem reported 44 cases iii 112 children, the
youngest being 2 months old. Gyorko observed it in no infants in a group of
240 cases in the Canaries. There are no detailed data on its incidence in
children in the tropics and it is therefore impossible to compare the incidence
there and in temperate climates. We beheve however that use of Wood's hght
might facihtate the diagnosis of most cases in ehildren in the tropies.
On the basis of our examination, we can state that pityriasis versicolor
occurs even in children in the first year of life. It becomes commoner in older
children : over 7 years it is very frequent (23-5%) and is commoner in girls
than boys, wliich agrees with the sex incidence in adults, for according to
ICrzystaiowicz (1928) and Duk (1962), it is more frequent in men than women.
The distribution of the lesions is similar in ehildren and adults except in so far
as we have not seen it on the abdomen, neck, arms or face in children. There
are also chnical differences in adults and children : in the latter the patches do
not show pink, yellow or yellowish-brown colouring and there is no yellowish-
green fluorescence under Wood's light. The microscopic picture in children is
also worthy of notice, a characteristic feature being the small number of
spherical spores compared with the large number of filaments whieh may be
two or three times longer than those seen in adults. Is it not possible that the

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400 R. MICHALOWSKI AND H. RODZIEWICZ

fluorescence of pityriasis versicolor in adidts is due to the greater numbers of

spores present in the lesions ?
SUMMARY.
Pityriasis versicolor is common in children in a temperate elimate, even
occurring during the first year of life. Among 305 children aged 4 months to
10 years examined under Wood's light there were 33 eases {10-8%).
Wood's light is invaluable in the detection of pityriasis versicolor in children
for the lesions are usually invisible in daylight.
Microscopically, the picture in children is characterized by tho small number
of spores and the relatively large number of crescentic tlireads, sometimes
twice or thrice as long as in adults.

REFERENCES.
DuK, A. W. {1962) Vest. Derm. Wener., 35, 61.
GYOHKO, A . C. (1951) Clin. Lab., Saragosa, 52, 108.
JACOBSON, F . W , and JKLLIFFE, D . B . (1955) Z. Haul.-u, Oeschlechtakr., 18, 9.
KitzYSZTALOwicz, F. (1928) Choroby Sk6}-y. Warsaw.
VANBHEUSEUHKM, R . (1950) Ann. Inst. Pasteur, 79, 798.