$Unique_ID{BRK01502}
$Pretitle{}
$Title{Summer Tan Ruined by a Skin Rash}
$Subject{skin fungus color subcutaneous tissue tan rash infection tinea
versicolor fungal yeast pityrosporum orbiculare brown scaling lesions chest
neck abdomen colorations potassium hydroxide spores hyphae spaghetti meatballs
itching salicylic acid sulfur scales selenium sulfide imidazoles ketoconazole
fungi tans rashes infections scale lesion spore itch itches}
$Volume{L-20,A-20}
$Log{}

Copyright (c) 1991-92,1993   Tribune Media Services, Inc.


Summer Tan Ruined by a Skin Rash


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QUESTION:  A perfectly beautiful summer tan has been ruined by a skin rash
that is very difficult to treat.  Even my doctor admits it is changing the
color of my skin, and says the rash is due to an infection that is named for
it ability to change skin color.  All of this is very upsetting, and I need
some more information.  Can you please tell me what this is all about?

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ANSWER:  I'll try, but only because you have given me the clue that I needed
to understand your situation.  Skin problems are hard enough to diagnose when
you can see them, but your mention of your doctor's comments make it fairly
certain that this is a case of tinea versicolor.  This is a very common fungal
skin infection, with the yeast Pityrosporum orbiculare being the culprit.
Typically it causes a group of tan or brown, very slightly scaling lesions on
the chest, neck, abdomen and occasionally on the face.  Since the skin
affected by this infection does not tan, a white patch is seen against the
bronzed background.  And it is these different colorations that give it the
name "versicolor".  Besides its distinctive appearance, the infection is
diagnosed by observing scrapings from the lesions under the microscope.  After
treatment with potassium hydroxide, the typical microscopic appearance of
yeast spores and hyphae (sometimes called spaghetti and meatballs) can be
observed.  The condition is one that recurs frequently and may become
symptomatic, with itching the principle complaint.  There are a number of
possible treatments.  Careful cleansing with medicated soap containing
salicylic acid and sulfur helps to remove the scales and remove the fungus.
Selenium sulfide is also effective, although the sulfur smell is pretty strong
and disliked by most patients.  Topical treatment with creams containing
imidazoles is effective.  An oral medication, ketoconazole, can also be used,
although not yet approved for this indication by the Food and Drug
Administration.  Ketoconazole has some potent side effects, and so the risk
may be too great for a skin lesion of this nature, but very small doses (as
little as a single 200 mg dose every two weeks for a maximum of six doses) may
be sufficient to gain the desired results.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.