Hi, welcome to XXXXXXX
Thanks for query.

You are having tinea versicolor, may be called sobi in local language.

Tinea versicolor is caused by yeast called Malassezia furfur that normally lives on the skin of most adults without causing problems. It exists in two forms, one of which can cause patches of discolored slightly scaly skin. Factors that induce the disease are poorly understood, but high humidity and immune or hormonal changes may play roles. Nevertheless, most people with this very common condition are perfectly healthy.

Tinea versicolor occurs if ...
You have oily skin
You live in a hot climate
You sweat a lot
You have a weak immune system

Common causes:
Infection is caused by Malassezia furfur
Lipophilic yeasts Pityrosporum orbiculare (round form) and Pityrosporum ovale (oval form) are saprophytes
These organisms are normal inhabitants of skin flora but change from the saprophytic form to the hyphae form of Malassezia furfur
Depigmentation is due to the fungus producing azelaic acid, which inhibits tyrosinase activity, which in turn is involved in the process of normal melanization.

Contributory or predisposing factors:
Pregnancy
Malnutrition
Immunosuppression (including use of tumor necrosis factor inhibitors)
Oral contraception
Excess heat and humidity (heavy clothing with perspiration)

Remember...
#Good nutrition, hygiene, and a cool climate prevent tinea versicolor
#Immunosuppression can predispose a patient to tinea versicolor
#Malnutrition can lead to tinea versicolor
#Good nutrition (6-8 servings of fruits and vegetables a day with limited intake of sugar and simple carbohydrates) will prevent recurrence
#Excessive perspiration can lead to tinea versicolor
#Reduce the heat and humidity in the living environment to prevent recurrence
#Oral contraceptives may predispose to tinea versicolor...Other means of contraception may be indicated

Treatment:
Tinea versicolor can be successfully treated with various agents. Effective topical agents include selenium sulfide, sodium sulfacetamide, ciclopiroxolamine, as well as azole and allylamine antifungals. Various regimens can be used. Selenium sulfide lotion is liberally applied to affected areas of the skin daily for 2 weeks; each application is allowed to remain on the skin for at least 10 minutes prior to being washed off. In resistant cases, overnight application can be helpful. Topical azole antifungals like..clotrimazole,miconazole,ketoconazole..etc.can be applied every night for 2 weeks. Weekly application of any of the topical agents for the following few months may help prevent recurrence. In patients with widespread disease, topical antifungal therapy can be expensive. Topical allylamines have been demonstrated to be clinically and mycologically effective.

Do shampoo with shampoo containing ketoconazole, daily.

Oral therapy is also effective for tinea versicolor and is often preferred by patients because it is more convenient and less time consuming. Of course, oral therapy can be used in consort with topical regimens. Ketoconazole, fluconazole, and itraconazole are the preferred oral agents. Various dosing regimens have been used. With ketoconazole, a 10-day 200-mg daily therapy and as a single-dose 400-mg treatment are popular, both with comparable results. Fluconazole has been offered as a single 150- to 300-mg weekly dose for 2-4 weeks. Itraconazole is usually given at 200 mg/d for 7 days. Pramiconazole and sertaconazole have also been used in the management of tinea versicolor.

If you have query still, you are welcome.

Regards with best wishes..

Dr. Ilyas Patel MD

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