Lichen versicolor: symptoms in humans, photos, treatment and medications. Pityriasis versicolor (varicolored) - photo (what spots on the skin look like), causes and symptoms, diagnosis. Treatment of pityriasis versicolor in children, in adults - drugs, physiotherapy

Versicolor versicolor (synonyms - pityriasis versicolor, Tinea versi-color) is a fungal disease related to keratomycosis. Characterized by damage to the superficial part of the stratum corneum of the skin and hair cuticle. Manifestations of this disease create aesthetic problems, reducing the quality of life.

The disease was first described in 1853 by S. Robin, who discovered a yeast-like microorganism in the skin scales of a patient with lichen versicolor and named it Microsporum furfur. Later, in 1889, in order to distinguish this microorganism from the genus Microsporum (dermatophytes), Bayon (N. Vashop) proposed another name for the fungus - Malassezia furfur. The genus is named after the French botanist L. Malassez, who described round and oval budding cells in the stratum corneum of the epidermis of patients with lichen versicolor.

Until now it remains actual problem pathogenesis of lichen versicolor. There are many theories explaining the occurrence of this fungal disease.

Causes of pityriasis versicolor

Endogenous factors play a significant role in the occurrence of pityriasis versicolor.

Most common reasons the occurrence of versicolor versicolor or its relapse are: diseases gastrointestinal tract(GIT), respiratory organs, functional disorders of the central (CNS) and autonomic (ANS) nervous system, hyperhidrosis.

Often pityriasis versicolor occurs in women long time taking oral contraceptives. In 32.4% of the examined patients, foci of chronic infection were identified ( chronic tonsillitis, carious teeth, otitis, periadnexitis, pyelonephritis).

An important role in the occurrence of pityriasis versicolor is played by increased sweating, which can be caused by vegetative-vascular disorders, excessively warm clothing, long-term use of antipyretics and other reasons. From the anamnesis of the examined patients, it is known that 52.9% suffer from excessive sweating.

Most often, lichen versicolor occurs in post-pubertal and mature adults, when the excretion rate sebum and the concentration of lipids on the skin surface is maximum. Of great importance in the occurrence of pityriasis versicolor is not only increased sebum secretion, but also a change in chemical composition sebum. In sebum there was an increase in the content of free fatty acids(oleic, palmitic, linoleic, stearic, myristic).

Symptoms of versicolor

Pityriasis versicolor is characterized by diversity clinical manifestations. Fitzpatrick et al. (1987) identify three main clinical forms Lichen versicolor: 1) erythematosquamous, 2) follicular, 3) invert.

The most common form is erythematosquamous. The site of primary localization of the fungus and the source of relapses are the mouths of the pilosebaceous follicles. Here it reproduces, forming colonies in the form of yellowish-brown dots. During the process of peripheral growth, these initial elements turn into round, sharply defined, non-inflamed spots up to 1 cm in diameter. Merging, the spots form large lesions the size of a palm or more. Such lesions have scalloped outlines, with isolated spots scattered along their periphery. With a long course of mycosis, the lesions can occupy large areas of the skin: the entire back, the sides of the body, and the chest. Usually these are yellowish-pink rashes of varying intensity. However, the color can vary significantly: from pale cream to dark brown. At frequent washing the scales are barely noticeable, but when scraped, fine-plate peeling easily occurs (Beignet's symptom). Peeling of spots can be detected by smearing their surface and surrounding healthy skin with an alcohol solution of iodine or aniline dyes. As a result of intensive absorption of the solution by the loosened stratum corneum, the affected skin is colored much brighter than healthy skin (Balzer test). Mycosis is localized mainly on the skin of the chest and back, somewhat less often on the skin of the upper extremities, neck, and even less often on the skin of the lower extremities.

The course of the disease is chronic, prone to relapses. Subjective sensations are usually absent, but sometimes there is slight itching. Complaints are usually related to the presence cosmetic defect skin, since the lesions do not become pigmented under the influence of insolation or artificial ultraviolet irradiation. The post-eruptive spots that form in this case look light against the background of a general tan, which creates a picture of pseudoleukoderma.

At lichen versicolor Widespread and limited rashes are observed. The prevalence of the process is assessed depending on the area of the lesion. Limited lesions occupy less than 15% of the body surface, and widespread ones, respectively, more than 15%.

Lesions can be localized in atypical areas - on the face, skin ears, in the folds behind the ears, on the hands, forearms. The pathogen can be detected in the area of the inguinal-femoral folds, on the pubis, buttocks, inner thighs, and legs.

Treatment of multicolored lichen, drugs

For the etiological treatment of lichen versicolor, we selected two drugs: itraconazole (a triazole derivative, a synthetic broad-spectrum antimycotic) for systemic therapy and lamisil spray for local treatment. Their antifungal activity was studied using scanning electron microscopy.

Ultrastructural studies of M. furfur cultures in a scanning electron microscope made it possible to analyze the morphological changes occurring under the influence of itraconazole. It was revealed that the antimycotic causes profound destructive changes in the blastospores of M. furfur, leading to the death of the fungal cell. The disappearance of cell cytoplasm and collapse of cell walls were observed. Even in the absence of cytoplasmic lysis, noticeable morphological changes in blastospores were detected.

Based on this, we believe that itraconazole has high fungicidal activity and can be used in the treatment of patients with common and atypical forms of lichen versicolor.

Terbinafine (lamisil spray) treated 30 patients with limited forms of mycosis. Patients were recommended to treat the lesions with Lamisil spray twice a day for 7 days. Our ultrastructural studies of M. furfur cultures treated with terbinafine showed that the antimycotic causes destructive changes in blastospores, leading to the death of the fungal cell.

Clinical and mycological cure was obtained in 28 (93.3%) patients, of which 25 (83.3%) were treated with terbinafine for 7 days. In three (10.0%) patients, cure occurred after a second course of treatment, which was carried out after a week's break with the same dose. There was no therapeutic effect in two (6.6%) patients. As a result, they were cured after the use of itraconazole. During 10 months of observation, 86% of patients in the experimental group had no relapses.

Terbinafine has fungicidal activity and is effective in the treatment of limited forms of lichen versicolor. The drug was well tolerated; a side effect in the form of itching was noted in only one patient.

Disinfection of underwear and bed linen and examination of family members are of great importance. Shampoo is used to prevent tinea versicolor. Once a month (from March to May) for three days in a row, it is recommended to apply shampoo to the scalp and body skin for 5-10 minutes, and then rinse with a shower.

Analysis of the results of the study allows us to conclude that for common forms of lichen versicolor it is not advisable to carry out local treatment. In these cases good effect gives the use of systemic antimycotic drugs, such as itraconazole. At the same time, with a limited form of the disease, cure can be achieved with the help of external antimycotics, such as terbinafine.

In some cases, good results can be obtained using endolymphatic therapy.

Thus, in the treatment of pityriasis versicolor proper application antifungal drugs, enhanced by corrective therapy, gives persistent positive effect with a low relapse rate.

E. Bragina, Doctor of Biological Sciences,
A. Novoselov, Ph.D.,
Zh. Stepanova, Doctor of Medical Sciences

Article "Symptoms, treatment of versicolor versicolor, drugs"

Tinea versicolor (multi-colored) is infection, in which round, flaky patches of pink, yellow and Brown. As a rule, they merge with each other, forming vast surfaces with uneven edges.

The causative agent of the disease is opportunistic Pityrosporum fungus, which is present on the skin of 90% of people. Under certain conditions - decreased immunity, hormonal disorders, increased sweating- it activates, begins to multiply and leads to the development of changes in the skin. The disease is considered slightly contagious, but infection is possible through close contact with a patient and through common household items (domestic routes).

In Russia, 15% of the population suffers. Without treatment, the disease becomes recurrent, with periods of exacerbation in the summer months - pigmentation is disrupted in the affected areas, so large white areas form on tanned skin. Many diseases have similar manifestations. If symptoms resembling lichen appear, you should consult a dermatologist. The disease is not life-threatening and is slightly contagious, so treatment of tinea versicolor is carried out at home with medications prescribed by a doctor, in combination with folk remedies.

For treatment to be as effective as possible and take less time, it is necessary to:

Take a shower every day - increased activity of the sweat and sebaceous glands contributes to the proliferation of fungus.
Change underwear and towels daily, bed linen - at least once a week.
Boil the laundry in a soap-soda solution of 2% concentration, then be sure to iron it.
Do not use regular cosmetical tools for body.
Give preference to clothing made from natural fabrics, because synthetic materials disrupt air exchange, which increases sweating.
Adjust your diet: eat more vegetables, fruits, berries; limit sugar, baked goods.

How to treat tinea versicolor in each specific case will be determined by a dermatologist. With a small affected area and no concomitant diseases limited to local treatment: the use of antifungal drugs and keratolytic agents.

The products are produced in the form of solutions, creams, ointments and sprays. They are practically not absorbed into the bloodstream and have no effect side effects. Antifungal medications are applied to the affected skin 1-2 times a day until the lesions disappear.

Terbinafine, cream, spray;
Clotrimazole, cream, solution;
Ketoconazole, cream;
Ciclopirox, cream, solution;
Bifonazole, cream, solution.

The average duration of use of one ointment is 2 weeks, then it should be replaced with another.

Keratolytic agents

They soften the epidermis, promote exfoliation of affected cells and skin regeneration:

Demyanovich's method: first treat the lesions with a 60% solution of Sodium Hyposulfite, then wipe with a solution of 6% hydrochloric acid; perform once a day for 5 days;
once a day for a course of 3–5 days, treat the affected areas with a 20% solution of benzyl benzoate;
Salicylic-resorcinol alcohol treat lesions twice a day;
Salicylic alcohol and ointment 5% - treat lesions twice a day.

Shampoos

When lesions are localized on the scalp, shampoos containing antifungal substances are used instead of creams and ointments:

Ketoplus – active ingredients: pyriton zinc and ketoconazole;
Nizoral – contains ketoconazole;
Sulsena – contains selenium sulfide.

They are used twice a week, applied to the scalp, rubbed in, left for 5-10 minutes, and rinsed off. During treatment with the same agents, it is recommended to wash the body.

Systemic drugs

How to cure tinea versicolor if ointments and creams provide only temporary improvement? Antifungal (antimycotic) agents will help systemic action(pills). Modern drugs act selectively on fungal flora without causing dysbacteriosis:

Fluconazole (Flucostat), capsules, tablets – use 150 mg once a week for 1–2 months.
Introconazole (Rumicosis) – 100 mg per day for 2 weeks, then take a two-week break, while maintaining skin changes the course is repeated.
Ketoconazole (Nizoral) – 200 mg per day for 2 weeks.

Indications for their use:

ineffectiveness of local treatment within 4 weeks;
large volume of damage;
atypical forms of the disease;
signs of immunodeficiency in the patient.

Homeopathy

You can treat tinea versicolor at home with: homeopathic remedy Psoril. Release forms: cream, capsules, granules, shampoo, gel, spray. Has antipruritic, anti-inflammatory, antiseptic effect, promotes fast healing skin.

Psorilom cream contains extracts: milk thistle, lavender, mint, elderberry, violet. Apply twice a day to the affected areas.
Tablets and granules contain: potassium bromide, graphite, extracts of barberry, smokeweed and goldenrod. Take 1 tablet three times a day.
Shampoo and gel in addition herbal ingredients contain zinc, salicylic acid or birch tar. Use twice a week.

Patients usually tolerate Psoril well; no cases of overdose or adverse effects have been noted. The drug can be used in complex treatment diseases, it goes well with antifungal agents.

Folk recipes

When there were no effective antifungal drugs, people were treated with natural remedies. The most effective ways have reached our days. To achieve this, you can combine traditional methods with traditional medicine recipes.

Take St. John's wort herb, grind with a blender, mix with medical petroleum jelly in a ratio of 1 to 4, apply to the lesions once a day for half an hour. Apply until healing.
Grind St. John's wort herb, mix in equal parts with birch tar and butter. Apply the resulting composition to gauze and apply to the affected areas for half an hour daily.
Grind the sorrel leaves, mix with sour cream in a ratio of 1 to 2, lubricate the affected areas twice a day until healing.
Pour half a glass of buckwheat into three glasses of boiling water, simmer over low heat for a quarter of an hour, strain the broth, cool, wipe the skin three times a day.

These are also effective folk remedies:

Lubricate the affected areas apple cider vinegar up to 6 times a day for at least two weeks.
Pour calendula flowers with vodka in a ratio of 1 to 5, leave for a day, strain. Treat skin lesions three times a day. You can also purchase ready-made Calendula tincture at the pharmacy.
Take a small handful of regular beans, heat in a frying pan, then cool, grind in a coffee grinder, add olive oil until the consistency of thick sour cream, mix thoroughly, apply to affected areas once a day until the skin condition improves.
Take 15-20 fresh currant leaves, pour a liter of boiling water, simmer over low heat for a quarter of an hour, cover with a lid, leave for an hour. Wipe the skin with the resulting decoction or add it to water and take a bath.

How long should medications be used?

If you follow the doctor's recommendations, lichen versicolor in a person completely disappears in an average of a month, but sometimes this period lasts up to two months. Treatment must be continued until clinical and mycological recovery.

Basic external sign recovery – absence of peeling in the lesions.
Skin condition is monitored using fluorescent lamp– there should be no yellow-brown glow in the lesions.
Microscopy method - no threads of fungal mycelium should be detected in skin scrapings.

After recovery in for cosmetic purposes conduct a course of ultraviolet irradiation of previously affected areas to even out skin color.

Relapse Prevention

Since tinea versicolor is caused by an opportunistic microorganism that is constantly present on the skin, there is a risk of relapse.

In order to prevent the disease from re-developing, it is necessary to establish the cause that contributes to the activation of the fungus. Must be excluded diabetes and hormonal disorders.
IN summer period for the purpose of prevention, use antifungal shampoo and shower gel twice a week.
Change your shower sponge at least once a month.
Iron bed linen and towels.
Sunbathing.

Treatment of lichen is a long process that requires patience and punctuality from the patient. A specialist will determine how and how to treat the disease. The patient’s task is to follow all his recommendations.

Pathology can be suspected specific features spots: localized on the entire body (shoulders, chest, sides of the body). Localization on the face is rare. Colored spots can be detected in the scalp using special diagnostic equipment.

In schoolchildren, rashes spread profusely, which is the reason for a careless attitude to personal hygiene. In adolescence, mycoses are actively widespread, since in boys and girls there are several provoking factors - instability of the reproductive system, excessive secretion of sebum, increased sweating.

Treatment of tinea versicolor in humans takes years, since the fungi are capable of forming a protective spore form under the influence of unfavorable factors, including meeting with medications.

Ringworm - what is it?

Exists folk way differences between tinea versicolor and its pink counterpart. After lubricating the skin first with alcohol and then with iodine, the color of the spot can be traced. The hue of the lesion changes when pityriasis versicolor, provoked by Pityrosporum orbiculare. The pathogen has a second name – “malassezia furfur”. The fungus belongs to the yeast family. Lives on skin person with strong immunity as a saprophyte (does not cause pathogenic changes). Skin lesions appear when the protective reserves of local and general immune complexes decrease.

Colored (multi-colored) lichen is so called due to the predominance of different shades of spots on the human body - from pink to brown. The term “pityriasis” was formed due to the appearance of small scales resembling bran. The nature of peeling is differential feature, allowing to distinguish this nosology from other dermatomycosis.

At fungal mycosis Only the stratum corneum is affected, so no deep changes are formed - there is no necrosis, addition of pyogenic flora, or ulcers. Superficial damage increases the frequency of infection of surrounding people, since the fungus is transmitted through clothing and bedding. It is preserved in scales with which the room and household items where the sick person resides are “saturated.”

Versicolor () lichen in humans is fungal infection stratum corneum of the epidermis. The disease occurs mainly in people young regardless of gender. It is relatively rare in children and is usually associated with chronic pathology leading to a significant decrease in immunity. More often, people living in areas with hot and humid climate. The disease is not accompanied by unpleasant symptoms, despite the unsightly appearance.

Without adequate treatment remain on the human body for a long time brown spots, which deprives the patient of self-confidence and gives rise to psychological complexes. In women, the disease often begins during pregnancy and after the birth of the baby, in addition to everyday problems, they are worried about the question: is lichen versicolor contagious or not? Understanding the processes occurring in the skin during interaction with a pathogen allows us to understand the essence of the pathology and the principles of effective treatment.

Briefly about the structure of the skin

Skin is a unique human organ, consisting of several layers, the most superficial of which is the epidermis (stratified keratinizing epithelium). Cellular composition The epidermis is renewed daily: dead cells fall off its surface, taking with them microbes, particles of dust and dirt. Such an organization is possible due to the intensive proliferation of cells of the basal (lowest layer) epithelium. Young cells gradually move upward, as they are replaced from below by younger epithelial cells. Gradually they accumulate keratin (a hard, durable protein), lose their core and die. Most upper layer The epithelium consists of horny scales - dead epithelial cells filled with keratin. On the surface they are loosely connected to each other and gradually fall off.

Living cells of the epidermis are so tightly connected to each other that even viral particles - the smallest pathogenic agents - cannot penetrate through them. The surface of the skin is additionally protected by a lipid film produced by sebaceous glands. Immune cells secrete protective proteins into the upper layers of the epithelium - secretory immunoglobulin A. They tie pathogenic microorganisms, getting on the skin, and prevents their penetration deeper. Secret sweat glands has a bactericidal effect due to another protective protein - lysozyme. Thus, human skin is reliably protected from the introduction of pathogenic agents from the external environment.

Pathogen

The causative agent of pityriasis versicolor is the opportunistic fungus Malassezia furfur. It lives on the skin of 90% of healthy people in the composition normal microflora in the form of inactive spores. Protective epidermal factors prevent the germination of spores, however, a decrease in their activity leads to the appearance of a vegetative form of the fungus - mycelium. Mycelium is actively reproducing cells of the pathogen that grow into the deep epithelial layers and cause a weak inflammatory process in them.

The protective reaction of the epithelium to the introduction of the fungus is the increased proliferation of cells in the basal layer. The renewal of the epidermis occurs more intensively in order to remove the pathogen from the body along with the horny scales. Therefore, the areas affected by the fungus intensively peel off with small pityriasis-like scales, which gave another name to pityriasis versicolor - “pityriasis versicolor.”

Immune cells react poorly to the fungus, since they are accustomed to its constant presence on the skin surface in the form of inactive spores. Immune protection mediated only humoral factors– blood proteins, which leads to the development of inflammation in the epidermis, similar to an allergic reaction. It is often ineffective and without treatment the disease lasts for years and often recurs.

The pathogenic form of the fungus is practically not contagious, but can be dangerous for people with reduced immunity: pregnant women, elderly, weakened children. How is the causative agent of lichen versicolor transmitted? Infection is possible when:

close physical contact with a sick person;
sharing bedding and underwear;
using common personal hygiene items (washcloth, towel).

Predisposing factors

As mentioned above, spores of the fungus Malassezia furfur live on the skin of most healthy people. However, for the development of pathology, certain conditions are necessary so that they can germinate. The main reasons for the appearance of multi-colored lichen:

pregnancy;
diabetes;
tuberculosis;
prolonged psycho-emotional stress;
exhaustion;
viral infection;
surgical intervention;
tumors;
HIV infection;
(excessive sweating);
treatment with glucocorticoids or cytostatics;
hypovitaminosis A.

Tinea versicolor during pregnancy occurs against the background of a natural decrease in immunity under the influence of hormonal changes. Most often, its symptoms appear after 5-6 months of gestation, since by this period oppression immune system becomes clinically significant.

Symptoms

The main symptoms of versicolor:

yellow/pink/light brown spots on the skin;
increased peeling of the affected areas;
slight itching.

Morphological elements of pityriasis versicolor are spots different colors. Initially they form around the mouths of hair follicles and gradually grow to significant sizes. Elements of lichen can merge with each other, forming figures with uneven contours. Their colors are different, so lichen is called multi-colored. Mature spots are usually dark brown or café au lait.

The edges of the lesions are flush with the skin surface and do not differ in feel from healthy tissue. Palpation does not cause any discomfort to the patient, and they do not disappear when pressed. The surface of the spots is covered with small white dry scales, which are easily removed by scraping. In some cases, peeling is revealed only by scratching.

The spots are located asymmetrically, that is, their localization may be different on the right and left half of the body. Most often they appear on the skin of the chest, back, neck, and abdomen. Less often - on the scalp, upper limbs, hips. In children and puberty spots spread widely over the skin, covering the neck, chest, back, armpits and limbs.

Why is tinea versicolor dangerous? Long-term persistent course of the disease leads to sensitization of the body - excessive activity of the immune response. A similar mechanism underlies skin allergic reactions, atopic dermatitis, contact dermatitis.

Diagnostics

A dermatologist diagnoses lichen versicolor. He examines the sick person, collects anamnesis, studies complaints and takes material for further research. Long-term course of the disease gradual increase spots in size, variability of their color and absence unpleasant symptoms- all these signs speak in favor pityriasis versicolor. In the anamnesis, as a rule, the doctor identifies any reasons for decreased immunity.

IN in doubtful cases A dermatologist has a number of clarifying tests for diagnosing lichen versicolor:

Balzer's test - a section of skin, covering the area of the stain, is lubricated with an alcohol solution of iodine. The fungus causes loosening of the stratum corneum, so areas of lichen are stained with iodine more intensely than healthy epidermis.
Besnier's sign ("shavings" phenomenon) - if you run the edge of a glass slide over the surface of the spot, the upper scales of the stratum corneum peel off in the form of small shavings.
Irradiation with a Wood's lamp - the light of a mercury-quartz lamp, passing through a glass Wood's filter, causes fluorescence in the cells of the fungi. Malassezia furfur produces a yellow or yellow-brown glow when exposed to radiation in a darkened room.

Additionally, microscopy of skin scales obtained from lichen spots is performed. To do this, the doctor scrapes the skin at the lesion with a glass slide and carefully collects scales on it. Next, the laboratory assistant soaks them in weak solution alkali and examines it under a microscope. The mycelium of Malassezia furfur is defined as thick, short, curved filaments, 2-4 µm in diameter. Along with them, fungal spores are found - round formations, covered with a two-layer capsule, arranged in the form of bunches of grapes.

Before treating lichen versicolor, the dermatologist prescribes a series of tests to determine the cause of the disease:

General blood test with leukemia formula - allows you to evaluate general state organism, quantity and ratio of different classes immune cells, suspect an immune disorder or chronic inflammatory disease.
Determination of blood glucose and tolerance to it - lichen versicolor in older people often indicates a violation carbohydrate metabolism. If a slight increase in fasting blood glucose is detected, a glucose tolerance test is performed. To do this, the patient is determined for sugar on an empty stomach, then given sweetened water to drink and the sugar content is determined again at regular intervals. If the glucose concentration does not return to normal within the allotted period, further research is carried out.
Biochemical blood test - provides indicative information about the work various systems body. Tinea versicolor can appear due to various chronic diseases, which can be suspected by changes biochemical composition blood.
Blood ELISA for antibodies to HIV - the infection has a detrimental effect on the cells of the immune system, which leads to immunodeficiency and a decrease in the activity of epidermal protective factors.

The listed indicative tests allow the doctor to narrow the scope of the diagnostic search for the root cause of the disease. Detecting and eliminating it is the key to successful treatment of lichen versicolor.

Therapy

A dermatologist knows best how to treat pityriasis versicolor, so consultation with him is necessary for every patient. Treatment is carried out on an outpatient basis; the patient does not require a certificate of incapacity for work. If, based on test results, the patient is determined to have impaired glucose tolerance, a diet is prescribed for lichen versicolor. It involves limiting simple carbohydrates to a physiological minimum. The patient needs to exclude sweets, sugary drinks, some fruits, White bread and baked goods, limit the consumption of potatoes, corn, and white rice.

The basis of treatment for lichen versicolor is:

Keratolytic drugs - they disrupt the connections between the horny scales, thereby accelerating the renewal of the epidermis and the removal of the pathogen from its thickness.
Antimycotic drugs - they violate life cycle fungus, prevent the proliferation of mycelium and its further spread.

For a limited form of the disease (one or several small lesions), the doctor prescribes antifungal drugs for topical use:

Fluconazole;
Terbinafine;
Clotrimazole;
Miconazole;
Ketoconazole;
Bifonazole.

An ointment or spray with an antimycotic is applied to the affected area and adjacent healthy tissue 1-2 times a day for a week. As a rule, such a course of treatment is sufficient to eliminate the manifestations of lichen. Its disadvantage is the high toxicity of antifungal drugs.

Alternative treatment regimens combine skin treatment with a keratolytic and natural antifungal drug. An effective remedy– 2% salicylic acid ( alcohol solution). It is applied with a cotton pad to the lesion, after which it is smeared with iodine or Fukortsin (Castellani paint) is used.

good therapeutic effect has a mash with salicylic acid, alcohol and resorcinol. It is prepared according to a prescription in state pharmacies. The product has a short shelf life, so to treat relapses you should order a fresh portion. A 2-4% solution of boric acid penetrates well into the affected tissues and stops the growth of Malassezia furfur mycelium. Treatment boric acid Contraindicated for children and pregnant women, as it has toxic effect when absorbed into the blood.

Treatment with the Demyanovich method is treatment of the skin with one of the following means:

20% benzyl benzoate solution;
10% sulfur-salicylic ointment;
60% sodium hyposulfite solution.

After them, 6% is applied to the lesions of lichen hydrochloric acid– it has a pronounced antifungal effect.

The doctor prescribes systemic treatment of lichen (tablets) for widespread skin lesions or persistent recurrent course of the disease. Intraconazole tablets are taken 100 mg 2 times a day after meals for 15 days. If ineffective, the course of treatment is repeated after 2 weeks. Therapy with antifungal agents negatively affects the liver, so the doctor monitors its condition when taking antifungal drugs orally. Treatment of lichen versicolor at home can only be carried out with products that do not contain antifungal components.

Preventive measures

To prevent relapses, it is recommended to use antifungal shampoos (Nizoral, Ketoconazole) from March to May. The product is used as a shower gel for 3 consecutive days, once a month. People who have been ill need to wear clothes made from natural fabrics - they allow sweat to evaporate from the surface of the skin and do not create Greenhouse effect, favorable for the development of fungus.

During treatment, the patient's bed linen should be disinfected in a 2% soap-soda solution. To obtain it, you need to dilute a tablespoon of soda in 1 liter. hot water and add shavings to it laundry soap. Linens are soaked in this solution for several hours and then washed. in the usual way. After washing, the laundry is ironed on both sides with steam to eliminate reinfection pathogenic form of the fungus.

Tinea versicolor is a marker of suppression of the immune system as a whole or a violation of the skin's protective barrier. Treatment skin manifestations must necessarily be combined with the search for the root cause of the disease and its correction. IN otherwise a person faces a series of long-term relapses of lichen, resistant to any therapy.

The word “lichen” itself known to medicine since the days ancient Greece, means absolutely various diseases skin, main feature which is the formation of flaky spots. Pityriasis versicolor, or versicolor versicolor - fungal disease, caused by a fungus from the genus of yeast – Malassezia furfur.

Malassezia furfur can also cause a disease such as.

A distinctive feature of the infection is practically complete absence inflammation and extremely low contagiousness. This is due to the fact that the growth of the microorganism occurs only in the most surface layers skin.

Causes

The fungus that causes pityriasis versicolor is our natural companion and is constantly found on human skin. However, the disease occurs only under certain conditions. Two factors matter: gender (young men or adolescents during puberty are more likely to get sick) and increased sweating(therefore, the disease usually occurs in countries with hot climates, as well as in vagotonic people).

Any immunodeficiency, incl. with diabetes, taking corticosteroids, poisoning, radiation, HIV infection, etc.

Symptoms of pityriasis versicolor in humans

The disease is localized mainly on the back and chest, less often on the neck, outer surface shoulders and scalp. The main symptom is the appearance small spots various shades of brown (hence the name multi-colored). The spots increase in size over time and merge with each other; the resulting lesions have a finely scalloped outline. There is barely noticeable peeling on the surface of the spots, so the appearance of the lichen is very similar to the surface of the bran.

Interestingly, during its life, the fungus purposefully inhibits the ability of cells to produce the black pigment melatonin, which is always formed when ultraviolet rays on the skin. Therefore, the areas of the epidermis affected by lichen do not change color during tanning, and in the summer they stand out against the general tanned background as white spots.

Is pityriasis versicolor contagious?

No. Fungi that cause lichen are already present on everyone's skin healthy person, located in the sebaceous glands. The reason for the occurrence of pityriasis versicolor is a decrease in the protective properties of the skin due to the reasons mentioned above.

How to treat pityriasis versicolor in humans

Currently, the main method of treating pityriasis versicolor (varicolored) in humans is therapy with local local antifungal drugs in the form of ointments, sprays, and shampoos. Very rarely, but still sometimes there is a need to use systemic tablets.

Since the causative agent of lichen is a yeast-like fungus, antimycotics that are effective against yeast are used to treat this disease.

This includes funds from several chemical groups(the current name of the drug and its brand name are given):

Imidazoles:

Ketoconazole = Nizoral
Bifonazole = Mycospor
Clotrimazole = Canesten
Isoconazole = Travogen
Econazole = Pevaril
Miconazole = Mycozolon
Oxiconazole = Mifungar

Triazoles:

Intraconazole = Orungal
Fluconazole = Diflucan

Allylamines:

Terbinafine = Lamisil
Naftifine = Exoderil

Selenium sulfide:

Selenium persulfide = Sulsen

The attending physician decides how to treat pityriasis versicolor in humans, but imidazole derivatives demonstrate the greatest effectiveness with fewer side effects. It should be said that if pityriasis versicolor occurs on smooth skin, then, as a rule, therapy only with external agents is effective. If vellus hair is involved in the process, and even more so long hair a combination of general antimycotics and local action. This is due to the fact that the fungus, localized in hair follicles, very difficult to respond local impact antimicrobials. Systemic antimycotics are also used for difficult to respond local treatment pityriasis versicolor.

When carrying out therapy, it is possible to use drugs of different chemical groups, for example, Nizoral or Sulsen shampoo in combination with Diflucan or Orungal capsules. Among external agents, preference is given to lotions and sprays, the application of which is technically simpler and more effective than the application of ointments and creams with which pityriasis versicolor is treated.

Forecast and prevention of relapses

The reverse development of spots occurs quite quickly, but it is quite difficult to eradicate the pathogen itself - it continues to live in the follicles of the hair and sebaceous glands. Therefore, pityriasis versicolor is prone to relapses, especially in the hot season. To prevent this from happening, two conditions must be met:

Do not self-medicate and undergo an adequate course of therapy under the supervision of a dermatologist. Many patients stop using antimycotics as soon as they receive the first cosmetic effect. This treatment is not radical: most likely, the lichen recurs.
Carry out a series preventive measures, preventing the development of fungus.

These include:

Daily change and ironing of clothes
Periodic disinfection of clothing and hats, as well as bed linen in a 2% soap-soda solution
Avoidance of wearing synthetic clothing(causes more significant sweating)
In the hot season - use antimicrobial drugs every 2-3 weeks on the area where lichen has occurred, or daily wipe the skin with weakly acidic solutions (vinegar, lemon juice), salicylic alcohol
Avoid stress and excessive sun exposure

Treatment at home with folk remedies

Treatment is based on the use of various herbal remedies that have slightly acidic properties (stop the growth of fungus) or direct antifungal activity (destroy fungus on the skin). How to treat pityriasis versicolor at home is up to you.

These include:

Oxalum ointment: prepared from a mixture of sour cream or cream with sorrel gruel. Treatment period – at least 10 days
Rue ointment or from St. John's wort: into a fat base (vaseline, butter) add crushed dried herbs or gruel from fresh plants. When mixed, an ointment is obtained, which is used to lubricate the area where the lichen spreads.

It is also possible to use ointments based on calendula, hellebore, celandine, and string - plants with pronounced antiseptic properties. During treatment, all the above hygienic preventive rules are observed.