PITYRIASIS VERSICOLOR | TINEA VERSICOLOR

PITYRIASIS VERSICOLOR SYN: TINEA VERSICOLOR      Pityriasis versicolor is a fungus infection of the skin characterized by superficial white or brown colored superficial lesions. These lesions are usually non-inflammatory covered with thin branny scales.      The causative fungus is pityrosporum orbiculare Syn: Malassezia furfur. This fungus is easily observed in epidermal scales. It can be grown in vitro only if oil is added to the medium i.e. lipophilic fungus. Clinical Types :      The lesions vary in color according to the normal pigmentation of the patient. The fungus interferes with the normal pigmentation, and lesion on the skin surfaces exposed to sun are usually lighter in color than surrounding normal skin, while those on covered portions of the body may be darker. Infections are usually asymptomatic and usually the patient seeks medical help for cosmetic reasons. Laboratory Diagnosis :      Adhesive-Scotche tape is usually used. The tape is applied to the skin in infected areas and then immediately sticked to a clean microscope slide and examined by high power objective. An alternative method is to collect scales with a blunt scalpel on a drop of 30% KOH with methylene blue under a cover-slip and then examined in the usual way for hyphae.      ●  Microscopic examination:  will show hyphae in epidermal scales short, curved and rarely branching. They are associated in clusters with spherical cells which may reach 8 microns in diameter.      ●  Isolation of the fungus in culture is not necessary for the diagnosis however, in culture, budding yeast-like cells predominate. Treatment :      A mild fungicidal and keratinolytic ointment will cure the infection. We may use imidazole derivatives like clotrimazole, and econazole. Also, Na hyposulphite 20% and selenium suspension are effective. Oral treatment with fluconazole is effective.