Which of the following is associated with this condition?

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#1

Which of the following is associated with this condition?

  • A. Malassezia furfur
  • B.Pernicious anemia
  • C. Pityrosporum orbiculare
  • D. Cutibacterium acnes (formerly Propionibacterium acnes )
  • E.Squamous cell carcinoma

Answers:

  • A. Malassezia furfur —Incorrect. Malassezia species are associated with pityriasis (tinea) versicolor, not PMH.
  • B.Pernicious anemia—Incorrect. Noncutaneous autoimmune disorders, such as Grave disease and pernicious anemia, have been shown to occur with higher incidence in patients with vitiligo. No association has been shown to exist between PMH and autoimmune disorders.
  • C. P orbiculare —Incorrect. P orbiculare has been suggested to be associated with confluent and reticulated papillomatosis because of its prevalence in some lesions in yeast form; however, this is not largely accepted as the pathogenic mechanism of confluent and reticulated papillomatosi because many lesions have not been found to contain the yeast. To our knowledge, it has no role in the development of PMH.
  • D. C acnes —Correct. In recent years, an association between PMH and C acnes colonization within the pilosebaceous unit has been consistently demonstrated.[3](javascript:void(0):wink: A certain subtype of the organism, phylogenetic type III, seems to be responsible.[4](javascript:void(0):wink: The characteristic hypomelanotic lesions are thought to result from bacterial production of a depigmentation factor that interferes with melanin synthesis, distribution, or both.[2](javascript:void(0):wink: This hypothesis is largely due to histopathologic analysis of lesions, which demonstrate decreased melanin content and melanosome distribution in the setting of a normal quantity and morphology of melanocytes. Additionally, the bacteria produce a type of porphyrin, explaining the diagnostic per-follicular fluorescence on Wood’s lamp examination.
  • E.Squamous cell carcinoma—Incorrect. The development of squamous cell carcinoma represents a long-term risk in skin affected by erythema ab igne. This association is particularly observed in patients exposed to hydrocarbon-fueled heat sources such as coal. No such association between PMH and cutaneous malignancy has been shown.