Tinea versicolor

Tinea versicolor


Tinea versicolor is a condition characterized
by a rash on the trunk and proximal extremities. Recent research has shown that the majority
of Tinea versicolor is caused by the Malassezia globosa fungus, although Malassezia furfur
is responsible for a small number of cases. These yeasts are normally found on the human
skin and only become troublesome under certain circumstances, such as a warm and humid environment,
although the exact conditions that cause initiation of the disease process are poorly understood.
The condition pityriasis versicolor was first identified in 1846. Versicolor comes from
the Latin, from versāre to turn + color. Symptoms
The symptoms of this condition include: Occasional fine scaling of the skin producing
a very superficial ash-like scale Pale, dark tan, or pink in color, with a reddish
undertone that can darken when the patient is overheated, such as in a hot shower or
during/after exercise. Tanning typically makes the affected areas contrast more starkly with
the surrounding skin. Sharp border
Pityriasis versicolor is more common in hot, humid climates or in those who sweat heavily,
so it may recur each summer. Sometimes severe “pin-prick” itching in the
affected areas; usually when the person’s body temperature is elevated by exercise or
a hot/warm environment, but the person hasn’t started sweating yet. Once sweating begins
the “pin-prick” itching subsides. The yeasts can often be seen under the microscope
within the lesions and typically have a so-called “spaghetti and meat ball appearance” as the
round yeasts produce filaments. In people with dark skin tones, pigmentary
changes such as hypopigmentation are common, while in those with lighter skin color, hyperpigmentation
are more common. These discolorations have led to the term “sun fungus”. Prevalence
This skin disease commonly affects adolescents and young adults, especially in warm and humid
climates. It is thought that the yeast feeds on skin oils as well as dead skin cells. Infections
are more common in people who have seborrheic dermatitis, dandruff, and hyperhidrosis.
Diagnosis Tinea versicolor may be diagnosed by a potassium
hydroxide preparation and lesions may fluoresce copper-orange when exposed to Wood’s lamp.
The differential diagnosis for Tinea versicolor infection includes:
Pityriasis alba Pityriasis rosea
Seborrheic dermatitis Erythrasma
Vitiligo Leprosy
Syphilis Post-inflammatory hypopigmentation
Treatment Treatments for tinea versicolor include:
Topical antifungal medications containing 2.5% selenium sulfide are often recommended.
Ketoconazole is another treatment. It is normally applied to dry skin and washed off after 10
minutes, repeated daily for 2 weeks. Ciclopirox is an alternative treatment to ketoconazole
as it suppresses growth of the yeast Malassezia furfur. Initial results show similar efficacy
to ketoconazole with a relative increase in subjective symptom relief due to its inherent
anti-inflammatory properties. Other topical antifungal agents such as clotrimazole, miconazole
or terbinafine can lessen symptoms in some patients. Additionally, hydrogen peroxide
has been known to lessen symptoms, and on certain occasions, remove the problem, although
permanent scarring has occurred with this treatment in some sufferers. Clotrimazole
is also used combined with selenium sulfide. Oral antifungal prescription-only medications
include 400 mg of ketoconazole or fluconazole in a single dose, or ketoconazole 200 mg
daily for 7 days, or itraconazole 400 mg daily for 3–7 days. The single-dose regimens,
or pulse therapy regimes, can be made more effective by having the patient exercise 1–2
hours after the dose, to induce sweating. The sweat is allowed to evaporate, and showering
is delayed for a day, leaving a film of the medication on the skin.
Some success with Senna alata has been reported. Recurrence is common and may be reduced by
intermittent application of topical anti-fungal agents like tea tree oil or selenium sulfide.
References External links
Health in Plain English – Tinea versicolor Tinea versicolor is harmless but can recur

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