Pityriasis Versicolor (Tinea Versicolor)

There are two distinct presentations:

1. reddish, brown, slightly scaly patches on upper trunk

2. hypopigmented area that will not tan, esp. in suntanned skin

   • May involve neck, upper arms, face and groin.

   • Scales removed by scraping show characteristic short stunted hyphae with spores on microscopy, ‘spaghetti and meat balls’ appearance.

Treatment

• Selenium sulfide (Selsun shampoo)—wash area, leaving on for at least 10 mins, or overnight, for 7–10 days and/or

• Econazole 1% (Pevaryl) foaming solution—apply to wet body (after shower):

  • – rub in from head to toe

  • – do not rinse, allow to dry

  • – shower off next morning

  • – apply for 3 consec. days

• Ketoconazole shampoo, once daily for 3–5 min, then wash off, for 5 d

• For persistent or recurrent problems, fluconazole 400 mg (o), as a single dose

• For prophylaxis, itraconazole 200 mg (o) bd for 1 day/month for 6 months