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Tinea Versicolor

-- History and Physical --

1. Hypopigmented or hyperpigmented lesions predominantly on the trunk caused by fungus Pityrosporum ovale (oval form) or obiculare (aka Malassezia furfur) 2. More common in areas of increased sebaceous glands

--- Diagnosis ---

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.

--- Treatment ---

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

--- References ---

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