Pityriasis Versicolor
exp date isn't null, but text field is
Pityriasis versicolor is a common yeast infection of the skin, in which flaky discoloured patches appear on the chest and back. It is sometimes called tinea versicolor. It is more common in hot climates, and often affects people that perspire heavily. It is a disorder of the healthy but florid cases are seen in the immunosuppressed such as those with diabetes mellitus, HIV/AIDS and topical steroid abuse.
Cause
- Pityrosporum orbiculare
- Pityrosporum ovale (malassezia furfur)
Symptoms
- Asymptomatic
- Mildly Itchy
- Pale or dark skin patches
Signs
- Hypopigmented macules and/or patches
- White scaly patches
Investigations
- Skin scraping for microscopy
- Fasting blood glucose (for florid cases)
- Retroscreen (for florid cases)
TreatmentTreatment Objectives
- To eradicate infection
- To prevent transmission
- To address predisposing factors
Non-Pharmacological Treatment
- Good personal hygiene
- Avoid sharing bath towels, sponges and clothing
Pharmacological Treatment
For Mild Tinea Versicolor
Evidence Rating: [C]
- Miconazole, 2%, topical,
Adults
12 hourly for 4 weeks
Children
> 2 years; 12 hourly for 4 weeks
< 2 years; 12 hourly for 4 weeks
Or
- Clotrimazole, 1%,
Adults
12 hourly for 4 weeks
Children
> 2 years; 12 hourly for 4 weeks
Or
- Whitfield’s ointment, topical,
Adults
12 hourly for 4 weeks
Children
Not recommended
Or
- Selenium sulphide, shampoo 2.5%, topical,
Adults
Once daily for 5-7 days (washed off after 30 minutes to prevent irritation)
Children
Once daily for 5-7 days
< 5 years; not recommended
For Severe Tinea Versicolor
Evidence Rating: [B]
- Itraconazole, oral,
Adults
200 mg daily for 7 days
Children
> 12 years; 200 mg daily for 7 days
1 month-12 years; 3-5 mg /kg daily for 7 days
Caution - Use of itraconazole is associated with potentially life threatening liver toxicity. Monitor liver function while on long term therapy.
Referral Criteria
- Refer intractable cases to a dermatologist.