A rare case of pityriasis amiantacea of the scalp posing differential diagnosis challenges to fungal skin infections

Background Pityriasis amiantacea is an uncommon clinical syndrome of the scalp with a particular reaction pattern seen in a number of inflammatory and infectious dermatoses such as seborrheic dermatitis, psoriasis, atopic dermatitis, contact dermatitis, lichen planus, pityriasis rubra pilaris and various superficial pyogenic or fungal infections. The syndromic diagnosis may be established by the infectionist or dermatologist by clinical examination; additional tests like histopathologic examination, bacteriologic, mycological exam and cultures are needed in order to diagnose the underlying disease, which in many cases remains unknown. The condition is characterized by thick, silvery, asbestos-like scales binding proximally the hair shafts. It is more common in women and in young patients. Common complications include temporary or scarring alopecia. The etiopathogeny, the methods of diagnosis as well as the management options are still being subjects for debate.