Lichen otripeda

Pityriasis versicolor (versicolor multi-colored) - a fungal disease of the skin.

Etiology, pathogenesis. The causative agent is the yeast-like fungus Pityrosporum orbiculare parasitizing the stratum corneum of the epidermis. Predisposing factors include excessive sweating, seborrheic diathesis.

Clinical picture. On the skin of the chest, back, neck, rarely the shoulder girdle and the scalp appear small (3-5 mm in diameter) non-inflammatory yellowish-brown spots with clear uneven borders, with the scraping of which reveals a slight otrubrious peeling. As a result of peripheral growth, spots grow in size and merge into large foci of so-called geographical outlines. Subjective sensations are absent. Apply a diagnostic iodine test, for which the affected skin is lubricated with iodine tincture and immediately wiped with alcohol: the horny layer loosened by the fungus quickly absorbs iodine and the stain of the pungent lichen stands out sharply, painted in a dark brown color against a slightly yellowed unaffected skin. Under the influence of ultraviolet rays (in particular, with sunburn) as a result of peeling on the places of the former rashes, the non-aggravating spots-pseudoleucoderma remain.

The diagnosis is based on a characteristic clinical symptomatology and a positive iodine test. In doubtful cases, microscopic examination of the skin scales is performed to detect the pathogen. Differential diagnosis is carried out in some cases with syphilitic roseola, which does not flake, does not merge into continuous foci, iodine test is negative, and serological reactions to syphilis are positive, there may be other manifestations of syphilis. The pseudoleucoderm should be differentiated from the true syphilitic leukoderm, in which the small rounded (0.5-1 cm) or marble pattern hypopigmented spots without clear boundaries are located on the slightly pigmented skin of the posterolateral surfaces of the neck, sometimes extending to the skin of the back; Positive serological reactions and other signs of syphilis make it possible to distinguish it from pseudoleucoderma.

Treatment. Rubbing of Andriasyan's liquid (urotropin - 5 g, 8% acetic acid solution - 35 ml, glycerin -10 ml), 2-5% salicylic-resorcinol alcohol, Wilkinson ointment, 10% sulfuric ointment, mycosolone, Demyanovich treatment (see. Scabies and other antifungal agents for 3-7 days, after which a general hygienic bath with soap and a washcloth is prescribed, and ultraviolet irradiation is indicated for cosmetic purposes to eliminate the pseudoleucoderm after antifungal treatment to prevent recurrence of the disease.