TINEA VERSICOLOR (PITYRIASIS VERSICOLOR)

• The term versicolor refers to the presence of both hyper and hypo pigmented lesions. It is a superficial skin infection that occurs most often in young adults during hot and humid weather caused by Malassezia globosa and malassezia furfur
• The infection is characterized by finely scaling hypo pigmented or hyper pigmented macules on the trunk and /or chest. Tinea versicolor despite its name , is not caused by Dermatophytes

• Malassezia species (Previously known as pityrosporum); most commonly Malassezia globosa and Malassezia furfur

Predisposing factors

• Warm and humid climate of tropics, pregnancy , serious underlying diseases, immune compromised host, Cushing’s syndrome, malnutrition

• A peculiar aspect of Tinea versicolor is its propensity to present as either hypopigmented or hyperpigmented, finely scaling, round or perifollicular coalescing macular patches found primarily over the trunk
• The eruption is almost always asymptomatic and only of cosmetic significance
• Colours vary; In Pityriasis versicolor alba there is pale patches (hypo pigmentation) and in Pityriasis Versicolor rubra reddish brown (hyper pigmentation) is seen
• Lesions do not tan in the sunlight, because of which they are more commonly noticed in the summer
• Common sites are the trunk and chest, but neck, abdomen, upper arms and thighs may also be affected

Differential diagnosis

• Vitiligo – characterized by depigmented macules without any scaling
• Seborrheic dermatitis- patches have an erythematous yellowish tint and scales are soft and greasy
• Pityriasis alba – characterized by poorly marginated, hypo pigmented, slightly scaly patches on the cheeks of young children

• Usually a clinical diagnosis is made
• Confirmatory test: Potassium hydroxide (KOH) preparation of skin scrapings reveals a spaghetti and meatballs pattern
• Ultraviolet wood lamp reveal a coppery orange or yellow fluorescence

Internal Medicines

• Nirgundyadi Kashaya
• Aragwadhadi Kashaya
• Patoladi gana Kashaya
• Krimighna vati
• Haridra khanda
• Aragwadarishta
• Khadirarishta
• Madhusnuhi rasayana

Procedures

• Sulfur containing ointments
• Nimbadi choornam / Eladi choornam with Takra
• Kshalana with vara choorna
• Guggulumarichadi taila – Ext application
• Kimsukapatradi taila – Ext application
• Adityapaka taila – Ext application
• Gandhaka taila – Ext application
• Rasothamadi lepa
• Patolamooladi sooksma choorna + jambeera swarasa ext application
• Panchavalkaladi taila – Ext application