Tinea versicolor
Revision as of 13:18, 9 June 2015 by Neil.m.young (talk | contribs)
Background
- Caused by fungus Pityrosporum ovale (oval form) or obiculare
- Also known as Malassezia furfur
Differential Diagnosis
- Pityriasis Alba
- Guttate Psoriasis
- Seborrheic Dermatitis
- Tinea Corporis
- Vitiligo
Diagnosis
- Hypopigmented or hyperpigmented lesions predominantly on the trunk
- More common in areas of increased sebaceous glands
- Equally common is light and dark skinned individuals, but more noticeable in the later
Workup
- Some demonstrate coppery-orange fluoresence under Woods Lamp
- KOH wet prep (Spaghetti and Meatballs appearance)
- Almost never cultured given difficult culture medium, benign course, and diagnostic KOH prep.
Management
- First line topical treatment is ketoconazole (nightly application x 2 weeks) or selenium sulfide (10 minutes x bid)
- 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
- Griseofulvin is not effective