Pityriasis Versicolor :Fungal Infection,Causes and Treatment

By: Dr Kashif Ahmed

I have seen pityriasis versicolor in my practice a lot of times and usually the patients are young boys and girls who perspire a lot or exercise in gymnasium. They accidentally find the spots on the back which can spread towards the neck and around up to the cheeks. The patients are usually terrified and many think it is white spot disease but i reassure the patient because the spot are not milky white and furthermore scraping can be done to confirm the diagnosis. After diagnosis is made i tell my patient it is a curable disease and start the treatment. Treatment is variable but severe cases need oral antifungal.

Causes

• It is common in tropical countries and it increases during hot and humid weather.
• The causative organism is pityrosporum orbicular in yeast-like form and when it becomes hyphet it is known as malasezia furfur.
• Those hypha and yeasts are found in skin scraping or scotch-tape stripings or on biopsy material PAS stein these hyper are found in the outer most layer of skin.

Clinical Features

• The lesions are without symptoms. Usually, they exist mainly on trunk and proximal parts of limbs with fine superficial scale observed after gently scraping with fingernails.
• White and un-tanned skin shows dark lesions with yellowish-brown scale but in dark and tanned skin there are light-colored lesions.

Diagnosis and Treatment

• Skin scrapings for direct microscopy and examination under wood’s light for pale yellow fluorescence can both be used to identify the organism.
• Topical treatment of choice is immediate whereas clotrimazole solution, miconazole cream and econazal creams and lotions are all effective.
• In widespread cases of pityriasis versicolor oral antifungal are used with local treatment.

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