If the pictures above is what you have or have had in the past then you have/had is PITYRIASIS VESICOLOR not ECZEMA.
ECZEMA is a term used to describe a family of skin conditions that cause skin to become irritated, swollen and many times itchy. Another name for eczema is “dermatitis”. Types of eczema include allergic contact eczema (e.g to poison ivy, nickel in costume jewelry), irritant contact eczema (e.g to battery acid), atopic eczema, hand eczema, nummular eczema, seborrheic eczema etc. Some types of eczema have a clear-cut cause while others have no fully understood causes. Eczema will be fully discussed in another post.
In our environs almost any rash, especially that seen in the pictures above is called eczema.
Back to the topic of the day. There are bacteria, fungi and other microorganisms that are normally resident on our skin and other parts of our body. PITYRIASIS VESICOLOR (PV) also called Tinea vesicolor is a very common skin condition that is caused by the excessive growth of one of those resident fungi called mallesesia furfur. Its excessive proliferation is encouraged by warm and humid climates, excessive sweating and sometimes an altered immune state as a result of corticosteriod use, undernutrition, pregnancy, diabetes etc. For this reason it is not contagious and cannot be contracted by sharing towels, clothing etc. It affects the trunk mainly, but can also affect the limbs and face. PV is commoner in young adults and affects all races and sexes.
This fungus in large numbers produce an acid called azelaic acid that bleach the skin in patches with some areas looking darker on exposure to sunlight. This is why the condition presents with alternating areas of light and dark scaly patches and islands of normal colored skin in between. It can be sometimes itchy especially after sweating. Other than the itching and cosmetic disfigurement, PV has no other health implication.
If in doubt or for confirmation, diagnosis can be confirmed by the dermatologist from a skin scrapping taken from the lesion that will show the yeast under the microscope. Also a woods lamp examination can be done- this will show a yellow flourescence.
PV is easy to manage. A selenium sulphide or ketoconazole shampoo works great as a 1st line treatment. More stubborn lesions require anti-fungal tablets and creams. Even after proper treatment, the discoloration can take months to disappear because we have to wait for the skin to reproduce pigment to even out the skin colour.
Many patients will have reoccurrences because the organism can’t be eradicted per say, its levels can only be lowered to a non—disease causing state. So when the condition is right again, especially when the weather is warm and humid or the altered immune state returns, it can re-occur. For patients that have frequent reoccurrences, maintenance therapy is encouraged. Once to twice weekly washing of the affected areas with a selenium sulphide or ketoconazole shampoo is sufficient in keeping the condition at bay.
Hope this was helpful. Please share with anyone that this will help…I am happy to answer any questions