The Current Understanding of the Clinical Condition Bahaq (Pityriasis Versicolor) – Hypothesis and A Review of Evidences

Abstract

Bahaq is a commonly encountered clinical condition of the skin. It is characterized by the presence of hypopigmented or hyperpigmented or erythematous macule which appears on the neck, chest, shoulder and arms. In classical literature, bahaq and its subtype bahaq abyad and bahaq aswad have been described. In a recent development, these Unani terminologies (bahaq abyad and bahaq aswad) have been correlated with the terminologies used in modern medicine for similar clinical presentation by the competent authority in India. The equivalent terms assigned for bahaq abyad as pityriasis alba and bahaq aswad as pityriasis nigra do not seem to be suitable. They lead to misdiagnosis and treatment failure. In this article, we have reviewed evidences from the literature to have current understanding of the clinical conditions bahaq abyad and bahaq aswad. The literature review showed that these two dermatological clinical conditions have an individual identity. They differ from each other in terms of clinical presentation, demographic characteristics, pathogenesis and treatment. Moreover, we have presented one case report of bahaq abyad and bahaq aswad each to have an understanding of its demographic characteristics, risk factors, clinical features and clinical course of the disease. We have diagnosed these cases as per descriptions mentioned in the classical literature and tried to correlate to the equivalent terms representing a similar clinical presentation in modern medicine. After a review of evidence, we hypothesize the most suitable equivalent terms for the clinical conditions bahaq abyad and bahaq aswad as pityriasis versicolor instead of bahaq abyad as pityriasis alba and bahaq aswad as pityriasis nigra. This research article may guide the Unani physicians in clinical practice for proper diagnosis, therapeutic approach, drugs selection and treatment of bahaq and its subtypes.