Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Updated: Dec 16 2021

Tinea Versicolor

Images
https://upload.medbullets.com/topic/120056/images/tinea_versicolor.jpg
https://upload.medbullets.com/topic/120056/images/mf spaghetti and meatballs.jpg
https://upload.medbullets.com/topic/120056/images/woodslamp.jpg
https://upload.medbullets.com/topic/120056/images/pityriasis_versicolor_frontal_retouche.jpg
https://upload.medbullets.com/topic/120056/images/tinea_versicolor1.jpg
https://upload.medbullets.com/topic/120056/images/kohprep.jpg
  • Snapshot
    • A 21-year-old man presents to his dermatologist for a rash on his face. He reports that there is no itch or pain associated with it. Although he spent a summer at the beach as a lifeguard and the rest of his face tanned, the area with the rash has not tanned, resulting in a white and yellow colored patches on his face. On physical exam, there are multiple yellow-white macules along his jawline and a large patch on his left cheek. There are also multiple similar patches on his trunk. A skin scraping and KOH preparation reveals tinea versicolor as a diagnosis. He is prescribed a medicated shampoo to use on his skin.
  • Introduction
    • Clinical definition
      • very common cutaneous fungal infection
        • characterized variably colored macules and patches
        • also known as pityriasis versicolor
    • Associated conditions
      • seborrheic dermatitis
  • Epidemiology
    • Prevalence
      • 30-40% in tropical climates
      • 1-4% in temperate climates
    • Demographics
      • most common in adolescents and young adults
    • Risk factors
      • hot and humid weather
      • excessive sweating
      • immunosuppression
  • Etiology
    • Malassezia spp.
      • formerly Pityrosporum
    • Pathogenesis
      • when there is excessive heat and moisture, there may be increased growth of Malassezia spp. compared with other normal flora
  • Presentation
    • Symptoms
      • asymptomatic
      • inability to tan in affected areas
    • Physical exam
      • macules and patches affecting the trunk, neck, and face
        • lesions have overlying fine scaling
        • variable color
          • pale yellow
          • white
          • hypopigmentation
          • hyperpigmentation
          • yellowish brown
  • Studies
    • KOH preparation
      • skin scrapings mixed with KOH
      • short multibranching hyphae and budding cells
        • “spaghetti and meatballs” appearance
    • Wood lamp examination
      • affected areas fluoresce yellow to yellow-green
      • < 50% sensitivity
  • Differential
    • Vitiligo
      • affected areas also fluoresce
      • lesions are depigmented
    • Eczema
    • Psoriasis
    • Seborrheic dermatitis
  • Treatment
    • Medical
      • topical treatment
        • indications
          • avoid systemic effects of oral medications
          • first-line therapy
        • drugs
          • zinc pyrithione 1% shampoo
          • selenium sulfide 2.5% shampoo
            • often also used for prophylaxis
          • ketoconazole shampoo
          • sulfur salicylic acid shampoo
          • azole creams
      • oral antifungals
        • indication
          • if disease is widespread or refractory to topical treatment
        • drugs
          • itraconazole
          • fluconazole
  • Complications
    • Areas of discoloration may be permanent
  • Prognosis
    • Often recurs
Card
1 of 0
Question
1 of 4
Private Note