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Pityriasis versicolor

Alternative Name:Tinea versicolor,Dermatomycosis furfuracea,Tinea flava

Definition:
Pityriasis versicolor is a condition characterized by a rash on the trunk and proximal extremities. Recent research has shown that the majority of pityriasis versicolor is caused by Malassezia globosa, although M. furfur is responsible for a small number of cases. These yeasts are normally found on the human skin and only become troublesome under certain circumstances, such as a warm and humid environment, although the exact conditions that cause initiation of the disease process are poorly understood.It is a common and relatively harmless fungal infection that results in patches of different pigmentation on the skin.

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The condition pityriasis versicolor was first identified in 1846.

It is estimated that 2 to 8% of the population of the United States has it. This skin disease commonly affects adolescents and young adults, especially in warm and humid climates. It is thought that the yeast feeds on skin oils (lipids) as well as dead skin cells. Infections are more common in people who have seborrheic dermatitis, dandruff, and hyperhidrosis.

Symptoms:
Pityriasis versicolor is a type of infection that appears as a tissue-thin coating of fungus on your skin. The signs and symptoms of Pityriasis versicolor are:

*Small scaly patches of discolored skin
*Patches that grow slowly
*Patches that tend to become more noticeable after sun exposure
*Possible mild itching

The patches can be various colors, including:

*White
*Pink
*Tan
*Dark brown

Although the discoloration may be more apparent on dark skin, the infection can affect anyone, regardless of skin color.

In people with dark skin tones, pigmentary changes such as hypopigmentation (loss of color) are common, while in those with lighter skin color, hyperpigmentation (increase in skin color) are more common. These discolorations have led to the term “sun fungus

The infection, which is most common in warm, humid temperatures, usually affects the:

*Back
*Chest
*Neck
*Upper arms

However, they’re not usually itchy or uncomfortable.

Causes:
The exact conditions that cause initiation of the disease process are not  very well understood.It is believed  that a number of factors may trigger this growth, including:

*Hot, humid weather
*Excessive sweating
*Oily skin
*Hormonal changes
*Immunosuppression — when your immune system is unable to protect your body from the growth of yeast or fungus on your skin or elsewhere

Healthy skin may normally have the fungus that causes this disorder growing in the area where hair follicles open onto the skin surface.Pityriasis versicolor occurs when the fungus becomes overgrown.

Diagnosis:
Doctor can diagnose Pityriasis versicolor with a skin exam. If there’s any doubt, he or she may take skin scrapings from the infected area and view them under a microscope.

Treatment:
Treatments for tinea versicolor include:

*Topical antifungal medications containing 2.5% selenium sulfide (Selsun shampoo in UK) are often recommended. Selsun Blue works for some people, but not all, because it only contains 1% selenium sulfide.  Ketoconazole (Nizoral ointment and shampoo) is another treatment. It is normally applied to dry skin and washed off after 10 minutes, repeated daily for 2 weeks. Ciclopirox (Ciclopirox olamine) is an alternative treatment to ketoconazole as it suppresses growth of the yeast Malassezia furfur. Initial results show similar efficacy to ketoconazole with a relative increase in subjective symptom relief due to its inherent anti-inflammatory properties.[9] Other topical antifungal agents such as clotrimazole, miconazole or terbinafine are less widely recommended[citation needed]. Additionally, hydrogen peroxide has been known to lessen symptoms, and on certain occasions, remove the problem, although permanent scarring occurs with this treatment.[citation needed] Clotrimazole (1%) is also used combined with selenium sulfide (2.5%) (Candid-TV).

*Oral antifungal prescription-only medications include 400 mg of ketoconazole or fluconazole in a single dose, or ketoconazole 200 mg daily for 7 days, or itraconazole 400 mg daily for 3–7 days. The single-dose regimens, or pulse therapy regimes, can be made more effective by having the patient exercise 1–2 hours after the dose, to induce sweating. The sweat is allowed to evaporate, and showering is delayed for a day, leaving a film of the medication on the skin.

*Some success with Senna alata has been reported.

*Recurrence is common and may be reduced by intermittent application of topical anti-fungal agents like tea tree oil or selenium sulfide.

Lifestyle and home remedies:-
For a mild case of Pityriasis versicolor, you can apply an over-the-counter antifungal lotion, cream, ointment or shampoo. Most fungal infections respond well to these topical agents, which include:

*Selenium sulfide shampoo (Selsun Blue)
*Miconazole (Monistat-Derm)
*Clotrimazole (Lotrimin)
*Terbinafine (Lamisil)

Wash and dry the affected area. Then, apply a thin layer of the topical agent once or twice a day for at least two weeks. If you’re using shampoo, rinse it off after waiting five to 10 minutes. If you don’t see an improvement after four weeks, see your doctor. You may need a stronger medication.

Prevention:
Avoid applying oil or oily products to your skin or wearing tight, restrictive or nonventilated clothing. Sun exposure makes the fungal infection more apparent.

To help prevent tinea versicolor from returning, your doctor can prescribe a topical or oral treatment that you take once or twice a month. Preventive treatments include:

*Selenium sulfide (Selsun) lotion applied to the affected areas every two to three weeks
*Ketoconazole (Nizoral) tablets once a month
*Itraconazole (Sporanox) capsules once a month

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://en.wikipedia.org/wiki/Tinea_versicolor
http://www.mayoclinic.com/health/tinea-versicolor/DS00635
http://www.bbc.co.uk/health/physical_health/conditions/pityriasisversicolor1.shtml

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