Pityriasis Versicolor Treatment

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Pityriasis Versicolor

Pityriasis versicolor (tinea versicolor) most commonly presents as small perifollicular, scaly, hypopigmented or hyperpigmented patches on the upper trunk in young adults. The perifollicular patches expand over time and become confluent. B. In tinea versicolor, fungus does not grow in standard fungal culture media (eg, Sabouraud's dextrose), but KOH examination shows the abundant spaghetti and meatballs pattern of short hyphae and round spores. Pityrosporon ovale is part of the normal flora of skin in amounts that are not detectable on KOH examination. It is a yeast infection, and it is not a dermatophyte infection.

Conditions with excessive numbers of warts

Ance of tinea versicolor-like macules. Rare patients experience neurological changes or ocular squamous cell carcinoma 53 . Malignant conversion of HPV-infected skin, due to UV exposure, is usually seen in early adolescence and continues through the patient's lifetime. Polymorphisms of IL-10 gene promoter causing reduced IL-10 production have been reported in Brazilian EDV patients. These polymorphisms are believed to promote skin cancer development 54 .

Miscellaneous Topical Antifungal Agents

Ciclopirox olamine (Loprox) is a pyridone derivative available for the treatment of cutaneous dermatophyte infections, cutaneous C. albicans infections, and tinea versicolor caused by Malassezia furfur. It interferes with fungal growth by inhibiting macromolecule synthesis.

Skin Diseases Caused by Fungi

Skin Disease

Diseases caused by fungi are called mycoses. Earlier in this chapter, we mentioned the role of normal flora yeast of the genus Malassezia in causing mild skin diseases, such as tinea versicolor. Other fungi are responsible for more serious infections of the skin, although even in these cases the condition of the host's defenses against infection is often crucial. The yeast Candida albicans (figure 22.26) may live harmlessly among the normal flora of the skin, but in some people it invades the deep layers of the skin and subcutaneous tissues. In many people with candidal skin infections, no precise cause for the invasion can be determined. Certain molds

Botulinum Toxin

Azelaic acid (Azelex) is a naturally occurring dicar-boxylic acid produced by the yeast Malassezia furfur. Azelaic acid inhibits tyrosinase, a rate-limiting enzyme in the synthesis of the pigment melanin. This may explain why diminution of melanin pigmentation occurs in the skin of some patients with pityriasis versicolor, a disease caused by M. furfur. Azelaic acid is bacteriostatic against a number of species thought to participate in the pathogenesis of acne, including Propionibacterium acnes. The drug may also reduce microcomedo formation by promoting normalization of epidermal keratino-cytes. Azelaic acid is used for the treatment of mild to moderate acne, particularly in cases characterized by marked inflammation-associated hyperpigmentation.

Other Imidazoles

A number of topical imidazoles are available for the treatment of cutaneous and mucous membrane candidi-asis, ringworm, and tinea versicolor. Butoconazole (Femstat) is an effective topical agent for vaginal can-didiasis terconazole (Terazol) is effective in the treatment of vaginal candidiasis and econazole (Spectazole) is useful in the treatment of superficial fungal infections of the skin, achieving high tissue levels in the stratum corneum. Oxiconazole nitrate (Oxistat) and sulconazole nitrate (Exelderm) are topical imidazole derivatives available for the treatment of dermatophyte infections and pityriasis (tinea versicolor). Tioconazole (Vagistat) is available without a prescription for the treatment of dermatophyte infections and candidiasis.

Defining wart types

Warzentypen Bilder

Flat warts (tinea versicolor-like) Tinea versicolor-like warts extensive flat warts When flat warts spread over a wide surface area and are either slightly hyper- or hypopigmented, they may mimic the appearance of tinea versicolor. This appearance is uncommon and is usually limited to patients with EDV, HIV infection, or other immune deficiency 23 .