Hyperpigmented patches.

TINEA VERSICOLOR

Tinea (pityriasis) versicolor (TV) is a superficial infection of the stratum corneum by the lipophilic fungus known as Malassezia furfur (formerly pityrosporum). The most common predisposing factor is excessive sweating but others include application of oils and systemic steroids.

• A superficial infection by the fungus Malassezia of the trunk, usually in young people with oily skin.
• Treatment is straightforward but maintenance is key as recurrences are common.
• Wood's light illumination shows a characteristic golden-yellow fluorescence.
• Oral ketoconazole should NOT be used as treatment for TV per the FDA--due to risk of severe hepatitis.

Clinical

The trunk is affected with brown, white, or pink, slightly scaly patches and very thin plaques. If no scale is appreciated, gentle scraping easily generates fine scale. Rarely, TV can affect other locations including the groin, sides of the neck and face. Atrophic lesions may occur. Folliculocentric TV has been reported.

Fluorescence

Malassezia fluoresces yellow-green with black (Wood's) light. In a study of 28 patients, 23 (82%) fluoresced positive with Wood's light. Positive KOH is the gold standard for diagnosis, but Wood's light is a rapid and inexpensive confirmatory tool.

Hypopigmented Patches

Many hypopigmented macules in a darker skinned patient.

RegionalDerm

Homepage | Who is Dr. White? | Privacy Policy | FAQs | Use of Images | Contact Dr. White