Tinea versicolor, also referred to as pityriasis versicolor, is a benign common fungal infection of the skin. It is characteristically caused by the organism Malassezia furfur.
It most commonly presents on the chest and back and appears as hypopigmented or hyperpigmented scaly patches on the skin.
The skin rash is most common in the summer months and frequently recurs.
The most common complaint from patients with this skin condition is a change in the color of their skin. Patients often report scaly patches that are either lighter or darker in color than their normal skin tone. The skin lesions range from a pale pink to salmon color.
The most frequently affected areas of the body are the chest, abdomen, back and upper arms. Patients also report that these skin lesions fail to tan in the summer months.
Tinea versicolor is typically diagnosed on physical exam alone.
Diagnosis can be confirmed with the use of an ultraviolet black lamp (Wood’s lamp), which reveals the coppery-orange fluorescence of the rash.
A potassium hydroxide (KOH) test can also be used as a confirmatory means. For this test, a blade is used to scrape the surface of a characteristic scaly patch and place it on a microscope slide for examination.
Positive results yield the appearance of hyphae, which look like “spaghetti and meatballs” under the microscope.
Tinea versicolor is caused by normal skin yeast and is not considered contagious.
It can be treated with an over-the-counter Selenium sulfide preparation or with prescription agents.
Oral antifungals such as Diflucan as well as a prescription topical antifungal can be used for resistant cases. Topical medication alone is generally recommended for one month.
Since tinea versicolor has a high rate of recurrence, prophylactic treatment with topical or oral antifungal therapy on an intermittent basis might be necessary in most cases.
Mandy Medlin, MSPAS, PA-C sees patients at the Bluffton office of May River Dermatology.
