Tinea versicolor

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Tinea versicolor

Synonyms: pityriasis versicolor   Major points •        Worldwide distribution •        Superficial chronic fungal infection •        Common
  • Majority of cases occur during adolescence
•        Family history is often positive   •        Clinical presentation:
  1. Discrete or confluent hypopigmented or hyperpigmented (brown) oval macules and patches with slight, fine scale
  2. Distribution over back,upper chest and shoulders, neck and proximal extremities
  3. The face is commonly affected in children (rarely in adults)
    Diagnosis •        Characteristic skin findings •        Wood’s lamp may aid in diagnosis of subclinical patches •        KOH preparation •        Culture/biopsy usually unnecessary   Treatment •        Topical therapy 1. Selenium sulfide 2.5% applied once a day for 7 days for 10 minutes, and washed off; then on the first and third day of the month for 6 months 2.      Propylene glycol 50% in water applied once or twice a day Topical azoles: ketoconazole, miconazole once or twice a day Topical terbinafine 1% cream   •           Systemic therapy: ketoconazole 400 mg in a single dose, repeated 1 week later; exercise to induce sweating increases skin concentration and increases effectiveness of systemic therapy     Prognosis •        Repigmentation may take months or years •       Recurrence rates high, 60–80%, with topical therapy
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