What is pityriasis versicolor?

Pityriasis versicolor, scientifically known as pityriasis versicolor, is also called tinea versicolor. It is a fungal infection of the stratum corneum of the skin caused by Malassezia. This disease is generally chronic. When the symptoms are more serious, it can cause hypopigmentation or pigmentation, and often occurs in the patient's face, armpits, upper arms, back and other parts.

1. Cause

The pathogen is a type of lipophilic yeast called Malassezia. This type of fungus is a saprophytic fungus of normal skin. Only under certain special circumstances such as high temperature and humidity, local fat and sweat, and poor sanitary conditions, the parasitic density of Pityrosporum increases and the saprophytic yeast transforms into a hyphae type to cause disease.

2. Clinical manifestations

The initial lesions are circular punctate macules surrounding the pores, which gradually increase to the size of a nail plate with clear edges. Adjacent areas may merge into large irregular patches, with new macules appearing around them. The surface is covered with a small amount of bran-like scales that are easily peeled off, ranging from gray, brown to yellow-brown, and sometimes multiple colors coexist, resembling spots.

The longer the time, the lighter the spots. The rash has no inflammatory reaction and occasionally causes mild itching. The lesions often occur on the chest and back, but may also affect the neck, face, armpits, abdomen, shoulders and upper arms. It is generally more common in young and middle-aged men. The course of the disease is chronic, with the rash decreasing or disappearing in winter but recurring in summer.

3. Treatment

1. Topical medications

2% ketoconazole lotion can be used externally for 7 to 10 days; 2% selenium disulfide lotion can be used externally for 7 to 19 days. For patients with smaller areas or those who cannot take oral antifungal drugs for various reasons, 1% bifonazole cream/gel, 2% miconazole cream, 2% ketoconazole cream, or 2% econazole cream can be given for external use, all of which have good therapeutic effects.

2. Systemic treatment

For patients with larger areas or recurrent attacks, oral azole drugs such as itraconazole, ketoconazole, and fluconazole can be given.