Transcript Tinea versicolor

Tinea versicolor
• caused by the yeast
Malassezia furfur
• the majority of pityriasis
versicolor is caused by
Malassezia globosa
• normally found on the
human skin
• Usually during warm and
humid environment
• Not contagious (normal
flora)
Symptoms
• Generally oval or irregularly-shaped spots of 1/4 to 1 inch
(0.6 to 2.5 cm) in diameter, often merging together to
form a larger patch
• Occasional fine scaling of the skin producing a very
superficial ash-like scale
• Pale, dark tan, or pink in color, with a reddish undertone
that can darken when the patient is overheated, such as
in a hot shower or during/after exercise
• Sharp border
• Sometimes severe "pin-prick" itching in the affected
areas; usually when the person's body temperature is
elevated by exercise or a hot/warm environment, but the
person hasn't started sweating yet. Once sweating begins
the "pin-prick" itching stops
Appear on the oily parts of
the upper body, usually on
the chest, back, and upper
arms. The spots are flat and
may be white, pink, red, tan,
or brown..
In people with dark skin
tones, pigmentary changes
such as hypopigmentation
are common, while in those
with lighter skin color,
hyperpigmentation are
more common. These
discolorations have led to
the term "sun fungus"
Diagnosis
• Inspection of the
spots
• Examine a scraping
of the infected skin
under a microscope
(KOH preparation)
– Spagetti and
meatballs apperance
Patient
• multiple pruritic slightly
erythematous with
hyperpigmented
patches
• lower abdomen,
inguinals and buttocks
• 2 months duration
• patches are welldemarcated
• with papules, vesicles,
scales and excoriarion
at the borders
Tinea Versicolor
• oval or irregularlyshaped spots 0.6 to
2.5 cm in diameter, may
merge to form patch
• chest, back, and upper
arms
• Sharp border
Treatment
• Topical antifungal medications
– .5% selenium sulfide (Shampoo)
– Ciclopirox (Ciclopirox olamine) alternative treatment to
ketoconazole as it suppresses growth of the yeast
Malassezia furfur
• Oral antifungal medications
– 400 mg ketoconazole or fluconazole in a single dose, or ketoconazole
200 mg daily for 7 days,
– Itraconazole 400 mg daily for 3–7 days.
– more effective by exercise 1–2 hours after the dose, to induce
sweating. The sweat is allowed to evaporate, and showering is delayed
for a day, leaving a film of the medication on the skin
Recurrence
• Often recurs after treatment, but usually not right
away, so that treatment needs to be repeated only
every year or two.
• Patches that are brown or reddish-brown resolve
quickly
• Spots that are lighter than the surrounding skin take
several months for overall color to even out.
• Tinea versicolor does not leave permanent skin
discoloration.