The skin is the external tissue of all vertebrates. In the human body, it is considered the largest organ, consisting of approximately 15% of a body’s weight. This size relates its dynamic nature and the significance of the skin in its multiple functions as a physical barrier and sensory organ. These barrier functions pertain to environmental elements, UV radiation, retention and expulsion of water providing for hydration and thermoregulation, and protection from organisms and physical injury.
The skin consists of three structural layers that enable these multiple functions, the epidermis, the dermis, and the subcutis. The epidermis is the outer most layer that in itself consists of five layers of stratified squamous epithelium, the basal, spinosum, granulosum, licidum, and corneum. The dermis underlies the epidermis and serves as the connective tissue between it and the subcutis. This tissue contains the hair roots, sweat glands, nervous cells, blood vessels, and lymph vessels. The innermost layer, the subcutis, consists of loose connective tissue and fat.
Tinea versicolor or pityriasis versicolor is a common skin infection in tropical climates such as Hawai'i. Colloquially referred to as Haole rot, kane, or tane, it is caused by the Malassezia yeast and is characterized by whitish discs on the upper torso. The research study I examined compared the clinical response between two treatments for the infection, a systemic fluconazole pill and a topical clotrimazole cream. The results determined that the clotrimazole cream had greater efficacy in the 2nd and 4th week resolution interval (Dehghan et. al., 2010). The fluconazole pill had greater efficacy in the 12th week resolution interval and had a decreased rate of reoccurrence. The study concluded that the clotrimazole cream is more effective in treatment and the fluconazole pill is more effective in preventing recurrence.
Dehghan, M., Akbari, N., Alborzi, N., Sadani, S., Keshtkar, A. (2010) Single dose oral fluconazole versus topical clotrimazole in patients with pityriasis versicolor: A double-blind randomized controlled trial. Journal of Dermatology, 37, 699-702.
Gawkrodger DJ. (2002). Dermatology, An Illustrated Colour Text. 3rd ed. Edinburgh: Churchill Livingstone.
Johnson, M.D. (2010). Human Biology: Concepts and current issues. San Francisco. CA: Pearson Benjamin Cummings.
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