Tinea versicolor

Question 1

caused by

Answer 1

Malsseezia spp

major sp- m globosa

Question 2

lesions

Answer 2

hypo/hyper coalescing scaly macules on the trunk and upper arms. pink atrophic and teichrome variants.
more on summer months and favors oily areas.

Question 3

Sites of predilection

Answer 3

sternal; sides of chest; abdomen, back, pubis, neck, interrrigenous areas.

Question 4

microscope

Answer 4

Short thick funal hyphae and large numbers of various sized spores. “spaghetti and meatballs”

Question 5

woods light

Answer 5

Yellow green fluoresence

Question 6

biopsy

Answer 6

Thick basket weave stratum corneum w hyphae and spores

Question 7

Tx

Answer 7

Imidazole, triazole, selenium sulfide, ciclopirox, olamine; zinc pyrithione, sulfur prep, salicylic acid; propylene glycol, benzoyl peroxide - Topical agents.

selenium sulfide lotion is very cost effective applied daily for a week washed off after 10 minutes. effective in single overnight application wc can be repeated monthly as prophylaxis.
scalp and teubk can be shampooed monthly w selenium sulfide to red scalp colonizarion.

Zinc pyrithione soap - cost effective. and well tolerated. for tx and prophylaxis.

adults: Oral itraconazole 200 mg OD for 7 days. or 400 mg singe dose.
fluconazole 400 mg once. and can be repeated monthly.

Oral terbinafine ineffective. Topical terbinafine is effective. 2x application is superior.

Question 8

tx cont

Answer 8

after initial tx px may prefer weekly washing w a topical zinc pyrithione bar or songle overnight application of selenium sulfide, ketoconazole, econazole, bifonazole shampoo every 30-60 days or monthly oral tx.