Tinea Versicolor

Tinea versicolor is a common skin condition due to overgrowth of a skin surface yeast. This overgrowth results in uneven skin color and scaling that can be unsightly and sometimes itch.

Tinea versicolor (pityriasis versicolor) is a chronic, superficial fungal infection that may produce a multi­colored rash, commonly on the upper trunk. Primarily a cosmetic defect, it usually affects young people, especially during warm weather, and is most prevalent in tropical countries. Recurrence is common.

Causes

Pityrosporum orbiculare (Malassezia furfur) causes tinea versicolor. Whether this condition is infectious or merely a proliferation of normal skin fungi is uncertain.

Symptoms

Usually, the only symptom of tinea versicolor is the white or light brown patches. Patches may scale slightly, but rarely itch or hurt. Other common characteristics of the rash include the following:

• white, pink, or brown patches
• infection only on the top layers of the skin
• the rash usually occurs on the trunk
• the rash does not usually occur on the face
• patches worsen in the heat, humidity, or if you are on steroid therapy or has a weakened immune system
• patches are most noticeable in the summer

Diagnostic tests

Wood's light examination strongly suggests tinea versicolor. Potassium hydroxide test of skin scrapings confirms tinea versicolor by showing hyphae and clusters of yeast.

Treatment

The most economical and effective treatment is 2.5 % selenium sulfide lotion applied once a day for 7 days. The lotion remains on the skin for 10 minutes and then is rinsed off thoroughly. In persistent cases, therapy may require a single 12-hour application of this lotion, followed by weekly washing with an antifungal soap.

More expensive treatments include topical anti­fungals, such as econazole, ciclopirox, and oral anti­fungals, such as itraconazole and ketoconazole.

Prevention

People with a history of tinea versicolor should attempt to avoid excessive heat or sweating. In addition, a dandruff shampoo applied to the skin area for 10 minutes each week may help prevent recurrences.

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