JOURNAL

FREQUENCY OF PITYRIASIS READING

VERSICOLOR IN DIABETIC PATIENTS
ATTENDING A TERTIARY CARE
HOSPITAL
Presented by :
Dewi Gotama

Supervised by :
Dr. dr. AAGP Wiraguna, Sp.KK(K), FINSDV, FAADV
 INTRODUCTION
PITYRIASIS VERSICOLOR (PV)
A superficial chronically recurring fungal infection of stratum
corneum

Characterized by scaly, dyspigmented, irregular macules >>

trunk & extremities

↑↑ Activity of
the sebaceous
40% of
Tropical Countries population
glands

<
 DIABETES MELLITUS (DM)

60 million a clinical syndrome of chronic and

people are
affected by
degenerative course caused by a
DM disorder in insulin secretion and/or
action which results in metabolic
changes, especially high blood
Skin Infection glucose
 62,2%
 As DM is very common and diabetic patients are
more susceptible to fungal infections

 The frequency of PV in diabetic patients is thought

to be high but very little work has been done on this
topic in our country
  To determine the frequency of pityriasis versicolor (PV)
OBJECTIVES in uncontrolled diabetes patients attending a tertiary
care hospital
METHODS  Desain study : Descriptive - cross-sectional

 Location and Time : Dermatology Department, Civil Hospital,

Karachi and Diabetic OPD Civil Hospital, Karachi -- 6 months
period from 1st May 2010 to 31st October 2010
 Data collection :

119 diabetic patients

Non-probability consecutive sampling technique

Version 10.0 of the SPSS.

Variables included were presence or absence of PV,

age, sex, and duration of diabetes
 Population and Sample
 Inclusion:
 Diabetic patients of ages 40-70 years, of either gender who presented in OPD

 Random Blood Sugar (RBS) >200 mg/dl

 Duration of diabetes >5 years

 Exclusion:
 Patients who were taking corticosteroids or immunosuppressive drug
 Table 1. Non-probability consecutive sampling technique

RESULTS
*) Out of 119 patients, there were 68 (57.1%) male and
51 (42.9%) were female patients
 Table 2. Presence of PV according to duration of diabetes

RESULTS
*) Out of 119 patients 5 (4.2%) had PV while remaining
114 (95.8%) patients did not have disease
*) 3 patients had diabetes since 5-10 years and 2 had
diabetes since 11- 15 years while those patients who
had diabetes since more than 15 years, none had PV
 Table 3. Presence of PV in different age groups

RESULTS
*) According to age, in 40-50 years age group 2 patients
had PV, in 51-60 year age group 2 patients and in 61-70
year age group 1 patient had PV
 DISCUSSION

 In our study, out of 119 patients -- 5 (4.2%) patients

were found to have PV
 Foss et al -- PV in 5.2% patients among diabetics

 Yosipovitch et al – PV in 8 of 238 (3.3%) patients with

type 1 diabetes of more than 5 years duration
 Other studies showed different results,
 200 patients with DM  in Raipur, Rajasthan -- a total of 122 (61%)
patients had some associated cutaneous diseases but none had PV

• 100 consecutive DM patients in New Delhi, fungal infection were seen in 21, but not
a single case with PV was detected
• 100 DM patients from Jammu, India, candida and dermatophytic infections were seen
in 10% and 8%, but not a single case of PV detected
 These differences in results may be because of
DISCUSSION difference in sampling technique, control of
diabetes, and difference in inclusion criteria
  Age  considered one of the most important factors in
PV, it mainly affect young subjects
 Karakas et al -- age groups mainly affected by PV were
DISCUSSION
those whose ages ranged 16-30 years (51.5%), 31-45
years (28.9%), 46-60 years (8.3%) and no patients in >60
years age group
  In our study, there was no significant difference observed
DISCUSSION in frequency of PV in different age groups, because our
study population was in 40-70 year of age group
 DISCUSSION

 In our study, out of 119 patients -- 3 males were and

2 females
 Nigam -- more males were affected by fungal infections
than female

 Kyriakis et al -- men had higher prevalence rates than

women
 CONCLUSION

 Pityriasis versicolor is not very common in

diabetic patients
 CRITICAL APPRAISAL

Valid ?

Important ?

Applicable ?
 A. Are the results of this cross-sectional study
valid ?
1. The study Address a clearly focused issue ? Yes

see page 241

 The aimed of the study was to determine the frequency of PV in uncontrolled
diabetes patients attending a tertiary care hospital

2. Did the Authors use an appropriate method to answer the question ?

Yes
see page 241
 The design of the study was cross-sectional
3. Were the subjects recruited in an acceptable way ? Yes
See page 242

 Study was conducted from 1st May 2010 to 31st October 2010 in Dermatology
Department and Diabetic OPD Civil Hospital

 In this study, diabetic patients of ages 40-70 years, of either gender who presented in
OPD, RBS >200 mg/dl, duration of diabetes >5 years were included in the study
4. Were the measures accurately measured to reduce bias ? Yes
See page 242
Patients were examined for PV and skin scrapings were taken for microscopy

5. Were the data collected in a way that addressed the research issue ? Yes
See page 242
In this study, study was conducted on 119 diabetic patients collected by non-probability
consecutive sampling technique
5. Did the study have enough participants to minimize the play of chance ?
See page 242 Yes
 Diabetic patients in Dermatology Department and Diabetic OPD Civil Hospital between
1st May 2010 to 31st October 2010 ; and 119 patients were included in this study
B. Are the valid result of this
cross-sectional study
important ?
1. How are the result presented and what is the main result ?
See page 243

- Out of 119 patients, only 5 (4.2%) patients were found to have PV while remaining 114
patients did not show any sign of PV

See page 244

- There was no significant difference observed in frequency of PV in different age

groups

2. How precise are the result ? Cannot be evaluated

3. Was the data analysis sufficiently rigorous? Yes
See page 242
 The data were analyzed using SPSS-version 10 -- frequency and percentage ; mean and standard
deviation

4. Is there a clear statement of findings? Yes

See page 242
 The principal finding from the population were diagnosed based on examined for PV and skin
scrapings were taken for microscopy
 C. Can you apply this cross-
sectional study in caring for your
patient ?
 Yes
1. The result be apply to the local population ?
 We can apply the results because the characteristics of our patient is not so different based on
gender, duration and have a different based on age

 However, studies determine the frequency of PV in uncontrolled diabetes patients attending a tertiary
care hospital

2. How valuable is the research ?

 Pityriasis versicolor in not very common in type 2 diabetes mellitus patients as it was thought before

APPLICABLE