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What to know about Pityriasis Versicolor (skin infection)


Dr. Shakirat Gold-Olufadi, Senior Registrar Dermatology and Genitourinary Medicine unit at Lagos University Teaching Hospital (LUTH), talks about Pityriasis Versicolor (also known as Tinea versicolor), causes and how to take care of it. GERALDINE AKUTU reports.

What is Pityriasis Versicolor?
Pityriasis versicolor (PV) is a fungal infection of the skin caused by an organism called Malassezia. There are different species of this organism that can cause this infection. The organism that causes PV is actually a normal commensal of the skin that can be found there in up to 90 percent of healthy individuals.

Studies have shown that there seems to be some genetic predisposition to the development of this condition and may be noted in family members of affected patients in up to 20 percent of cases. Other risk factors to developing the infection include immune suppression for any reason, such as malnutrition, HIV, chronic use of steroids on the skin, pregnancy and hot humid environments common here in Nigeria.

What causes it and what are the symptoms?
It usually causes more of a cosmetic nuisance without having many symptoms. Occasionally, some patients might complain of itching. In most cases, it appears as light coloured or dark coloured slightly scaly patches on the skin, especially in areas that have high production of sebum (oil), as the organism causing it likes the oil in such areas. The most commonly affected areas include the chest, back, upper arms, face and may sometimes extend to the scalp. It is a very common infection in the tropical areas and most people might report a history of previous episodes. It has a tendency for recurrence because of the genetic predisposition and the humidity of the environment. It is usually not contagious because the organism causing it is a normal commensal (resident) of the skin.

How is it diagnosed?
The diagnosis is usually made clinically before the skin is scraped and sent for a microscopical examination and culture in the laboratory.

What are the factors that increase the risk of developing Pityriasis Versicolor?
It should be noted that such practices as the chronic use of potent steroids present in triple action creams or in some bleaching creams, using medicated soaps which take away the natural and normal flora (microorganisms) of the skin all encourage recurrence of pityriasis versicolor.

It is also important to wear light coloured clothes that will reduce humidity rather than dark colored ones to reduce recurrence.

How can it be treated?
The treatment of pityriasis versicolor after confirmation is with the use of antifungal shampoos and creams. Occasionally, antifungal tablets might be needed. As part of management, it is important to educate the patient that the condition can recur, which does not mean treatment failure or inadequate treatment. It is also necessary to stress that even after treatment, the colour change that occurs with the infection might take up to six months or one year to return back to the original skin colour, especially when the accompanying colour change is lighter than the surrounding skin.

In conclusion, PV is a relatively common fungal infection of the skin that has a tendency for recurrence, especially in tropical regions. It should be stressed that self-medication and the use of remedies, such as brake fluid and hydraulic oil are strongly discouraged, as these are not recommended treatment and can cause further damage to the skin.

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