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Clinical Summary

Tinea versicolor, or pityriasis versicolor, is a chronic, superficial fungal infection that involves the trunk and extremities with rare facial involvement. The fungus is part of normal skin flora. Finely scaling brown macules are present in fair-skinned patients, whereas scaly hypopigmented macules are often noted in dark-skinned patients.

Management and Disposition

Treatment consists of short applications of selenium sulfide lotion, topical antifungal creams, or topical ketoconazole. Resistant cases require referral and consideration of oral antifungal.

Pearls

  1. Tinea versicolor is more common in adolescents and young adults.

  2. Clinically active areas or areas colonized with the fungus may be identified by orange fluorescence noted on the Wood lamp examination.

  3. Normal pigmentation may take months to return.

FIGURE 13.98

Tinea Versicolor. Multiple, small-to-medium-sized, well-demarcated hypopigmented macules on the back of a tanned individual with white skin. (Used with permission from Wolff K, Johnson RA, Saavedra AP. Fitzpatrick’s Color Atlas & Synopsis of Clinical Dermatology. 7th ed. New York, NY: McGraw Hill; 2013: Fig. 26-19.)

FIGURE 13.99

Tinea Versicolor. An example of hypopigmented areas on dark skin. (Photo contributor: James J. Nordlund, MD.)

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