Pityriasis Versicolor (Tinea Versicolor)

Last updated 30.03.13

 

Index

 

Definition

-  Scaly pink or pale patchy fungal skin infection

-  Pityriasis (Greek) refers to scales appearing similar to bran

-  Versicolor refers to varying of colors

 

Features

-  Common skin complaint

-  More common in hot, humid environments or pts who sweat heavily

-  May recur each summer

-  Does not predispose to sunburn (even in pale patches)

-  Clinical Dx

 

Cause

-  Malassezia (yeast/fungi)

-  Malassezia globosa

-  Malassezia sympodialis

-  Malassezia furfur

 

Associated S/S

-  Rash

-  Flaky discolored patches

-  Typically on trunk, back, neck or arms

-  Pink, coppery brown or paler than surrounding skin

-  Pale patches more common in darker skin (Pityriasis Versicolor Alba)

-  +/- Pruritis

 

 

 

Complications

-  Permanent white patches (not common)

 

DDx

-  Seborrhoeic dermatitis

-  Pityriasis rosacea

-  Vitiligo

 

Ix

-  Skin scraping for fungal MCS

-  +/- Woods light: yellow green fluorescence

 

Mx

-  Antifungals

-  Griseofulvin ineffective

-  Topical

-  Terbinafine 1% cream BD 1-4/52

-  OR Selenium sulfide 2.5% suspension to wet skin for 10min then wash off 10/7

-  OR Propylene glycol

-  OR Sodium thiosulphate 25% BD 4/52

-  OR Ciclopirox cream

-  OR Azoles

-   Clotrimazole BD 10-14/7

-   OR Econazole 1% to wet skin at night 3/7

-   OR Ketoconozole 2% shampoo daily for 10min then wash off 10/7

-   OR Miconazole 2% shampoo daily fror 10min then wash off 10/7

-  Extensive of persistant

-  Ketoconazole

-   400mg PO single dose

-   OR 200mg PO daily 7/7

-  OR Fluconazole 400mg PO single dose

-  OR Itraconazole 200mg PO daily 5/7

-  Vigorous exercise 1/24 post administration & avoid showring for several hrs improves effects as medication comes out in the sweat

-  May consider prophylactic treatment if recurrent

-   Ketoconazole 400mh PO once every 30-90days

-   OR Itraconazole 200mg PO once every 30-90days

 

 

 

References

 

DermNet NZ: Pityriasis Versicolor, 06/02/2013

Pic: www.globalskinatlas.com/imagedetail.cfm?TopLevelid=1081&ImageID=2566&did=458

eTG: Pityriasis Versicolor 2013