No abstract

Tinea versicolor (TV) is a common cutaneous fungal infection characterized by superficial scaling and a mild disturbance of skin pigmentation. It typically affects the chest, upper back, and shoulders. However, involvement of more unusual regions of the body such as the face and scalp, arms and legs, intertriginous sites, genitalia, areolae, and palms and soles has been reported. This report details two such cases observed at our institution: a 32-year-old woman with involvement of the popliteal fossa and a 16-year-old boy with involvement of the groin. The clinician must be aware of these variations in location and perform the appropriate diagnostic workup when lesions have the characteristic morphology of TV despite an unusual location. The etiology, pathophysiology, and epidemiology of TV are reviewed and current literature describing other instances of TV in uncommon locations is discussed.

We present a case of this disease in a 52 year old woman that has responded dramatically to the addition of oral cyclosporine to her existing regimen of oral acitretin, with significant improvement of skin lesions, mobility, and quality of life. Cyclosporine's mechanism of action in BFCP is poorly understood, although it possibly acts through inhibition of proinflammatory cytokines in keratinocytes or modulation of intracellular calcium. BFCP, the use of cyclosporine for its treatment, and possible mechanisms of action of cyclosporine are reviewed.

Individuals with inherited immunodeficiencies, autoimmune disorders, organ or bone marrow transplantation and with human immunodeficiency virus are particularly susceptible to developing severe, persistent and extensive manifestations of cutaneous human papillomavirus (HPV) disease. These complex cases require a unique and often multimodal approach to management. In this chapter, we discuss several states of immune compromise with increased susceptibility to HPV disease and review the literature on available management strategies including acitretin, cidofovir, Candida antigen, cimetidine, imiquimod, isotretinoin, fluorouracil, selenium, podophyllotoxin, photodynamic therapy, mammalian target of rapamycin inhibitors and the quadrivalent HPV vaccine.