Tinea versicolor

Background

• Caused by fungus Pityrosporum ovale (oval form) or obiculare1
• Also known as Malassezia furfur

DDx

1. Pityriasis Alba
2. Guttate Psoriasis
3. Seborrheic Dermatitis
4. Tinea Corporis
5. Vitiligo

Diagnosis

1. Hypopigmented or hyperpigmented lesions predominantly on the trunk
2. More common in areas of increased sebaceous glands
3. Equally common is light and dark skinned individuals, but more noticeable in the later

Work-Up

1. Some demonstrate coppery-orange fluoresence under Woods Lamp
2. KOH wet prep (Spaghetti and Meatballs appearance)
3. Almost never cultured given difficult culture medium, benign course, and diagnostic KOH prep.

Management

1. First line topical treatment is ketoconazole (nightly application x 2 weeks) or selenium sulfide (10 minutes x bid)
2. Single dose 400mg ketoconazole PO or fluconazole 150-300mg PO per week x 2-4 weeks for more resistant cases or for easy-of-use
3. Griseofulvin is not effective

See Also

• http://www.wikem.org/wiki/Tinea

References

• http://emedicine.medscape.com/article/1091575