Tinea Versicolor

Tinea Versicolor



Larry Denk, MD



Basic Information



Definition


Tinea versicolor is a superficial fungal infection of the skin caused by the yeast Malassezia furfur.



Synonym



Pityriasis versicolor


ICD-9-CM Code



111.0 Tinea versicolor


Epidemiology & Demographics



• Worldwide distribution; more common in humid and tropical climates

• Increased incidence in adolescence and young adulthood

• More commonly recognized in the summer, because hypopigmented lesions become more evident when the normal skin is darkened by sun and the lesions fail to tan

• Factors that seem to favor the overgrowth of Malassezia: pregnancy, excessive sweating, occlusion, malnutrition, immunosuppression, high plasma cortisol levels, oral contraceptives, and excess heat and humidity


Clinical Presentation



• Hypopigmented lesions can be red or hyperpigmented and usually occur on the chest and trunk, neck, and upper arms.

• Onset is insidious.

• Patients generally are asymptomatic, but some complain of mild pruritus.


Physical Examination



• Multiple oval, macular, and patchy lesions with fine scales are seen.

• Lesions may be hypopigmented or hyperpigmented (i.e., fawn-colored or brown), depending on the patient’s complexion and exposure to sunlight.

• Occasionally, lesions are salmon-pink or reddish.

• The lesions are usually distributed over the upper portions of the trunk (most common), neck, proximal arms, and occasionally, the face or other areas.

• Facial lesions are more common in children; the forehead is the most common facial site.

• Lesions may coalesce to involve a large contiguous area.

• Lesions can become lighter than the surrounding skin in summer and relatively darker during winter.

• Infections caused by M. furfur may manifest with follicular papules or pustules involving the same areas.


Etiology



• The infection is caused by proliferation of M. furfur, a lipophilic yeast that is a normal inhabitant of the skin flora.

• Under certain predisposing conditions, the yeast form undergoes a dynamic change to a pathogenic mycelial form associated with clinical disease.

• Nomenclature of these yeasts is confusing.
image Pityrosporum ovale and Pityrosporum orbiculare were previously used to distinguish M. furfur with an oval or round shape, respectively.
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Jun 19, 2016 | Posted by in PEDIATRICS | Comments Off on Tinea Versicolor

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