I HAVE YELLOW PATCHES ON MY BODY
Q I’m a 29-year-old woman and I have been suffering from yellowish white patches on my chest, upper back and arms for the past three months. I’ve suffered from similar rashes in the past as well. Now, my younger brother has also started developing similar skin lesions. The patches used to get better when I used Selsun shampoo but lately I’ve noticed that the shampoo is not having any effect on the patches.
A After reviewing your letter, I feel that the most probable clinical diagnosis of your skin complaint could be pityriasis versicolor, which is also called tinea versicolor. This is a fungal infection of the skin caused by a yeast fungus.
This fungus can live silently on our bodies but can become active and pathogenic with the ability to cause a dermatological condition. Heat, excessive sun exposure and profuse sweating usually precipitate its activity. In certain cases, the prolonged use of systemic antibiotics or partial suppression of the immune system due to various causes can also increase its ability to spread extensively.
The name of the condition – tinea versicolor – is suggestive of its clinical expression of changing the colour of skin on the affected areas.
This occurs due to the production of azelaic acid by the fungus, which suppresses as well as inhibits melanin production, resulting in skin patches of altered colours.
The colour of these patches can range from pinkish in the initial stages, after a few weeks they can become brownish in colour and later turn to whitish hypopigmented patches.
Potentially, this condition can be spread through direct body contact or by sharing bath towels or clothes.
Selsun shampoo, which you say you have used in the past, contains selenium sulfide, and has been an old first-line treatment option used for many decades. However, over the years, with increasing resistance of the fungus, selenium sulfide is losing its therapeutic efficacy in treating this condition.
I would recommend that you go to see a specialist dermatologist to confirm the suspected diagnosis. You most likely will require a course of oral antifungal medications together with topical antifungal creams and sprays to effectively treat your skin condition.
Avoidance of the abovementioned precipitating factors can help an accelerated recovery from your current skin ailment, as well as prevent any future recurrence.
DR IKRAMULLAH AL NASIR is a Dubai-based dermatologist