Tinea versicolor is a fungal infection of the skin caused by Malassezia species yeasts that normally live on the skin. It presents as scaly oval or round macules that often coalesce into irregular patches that vary in color. Diagnosis is made by visualizing the characteristic fungal elements using a potassium hydroxide preparation or potassium hydroxide-stained skin scraping under a microscope. Treatment involves topical antifungal medications. Regular use of topical agents helps reduce high recurrence rates.

1. TINEA (PITYRIASIS)
VERSICOLOR
Nuni Sulastri

2. TABLE OF CONTENTS
DEFINITION
01
EPIDEMIOLOGY
02
ETIOLOGY AND
PATHOGENESIS
03
CLINICAL
FINDINGS AND
LAB.TEST
04
PREVENTION
05

3. Tinea versicolor is a fungal
infection of the skin caused by
the yeast Pityrosporum orbiculare
(Malassezia furfur), a commensal
lipophilic fungus that lives in the
hair follicles and stratum
corneum.
01. DEFINITION

4. • The infection occurs more frequently
in regions with higher temperatures
and relative humidity
• Incidence of tinea versicolor is the
same in all races, but the eruption is
often more apparent in
darkerskinned individuals due to
resulting alteration in skin
pigmentation
• No sex predominance is apparent.
• Tinea versicolor is most common
among adolescents and young
adults, in whom lipid-producing
sebaceous glands are more active.
02. EPIDEMIOLOGY

5. ETIOLOGY AND PATHOGENESIS
03

6. ETIOLOGY
The infection is caused by Malassezia
species
(M. globosa, M. restricta, M. sympodialis, M.
furfur, M. obtusa, and M. slooffiae).

7. PATHOGENESIS

8. CLINICAL FINDINGS AND
LABORATORY TEST
04

9. Clinical Findings
The typical presentation of tinea versicolor is
scaly oval to round macules scattered over
characteristic areas of the body, including
the upper trunk, neck, and upper arms.
The macules often coalesce forming irregular
shaped patches of pigmentary alteration.
The color of patches varies from almost
white to
pink to reddish brown or fawn colored

10. Clinical Findings
Patches may have a wrinkled surface
appearance and this feature serves as a
useful clinical pearl for the diagnosis

11. DIAGNOSIS
The diagnosis made on clinical grounds is supported
by Wood's light examination which may show
yellow–orange fluorescence thought to be due to
the presence of pteridine and is confirmed by
microscopic KOH examination of the scale.

12. LAB.TEST
Potassium hydroxide (KOH) preparation of skin
scrapings demonstrates the characteristic fungal
spores and
short cigar-butt hyphae (“spaghetti and meatballs”)
Visualization of fungal elements may be enhanced
by the addition of methylene blue stain to the KOH
preparation
Culture is rarely necessary and requires a
lipid-containing medium (i.e., olive oil) to
demonstrate
growth.

14. PREVENTION
05
Recurrence is common and regular maintenance application of any of the topical agents
helps to reduce high rates of recurrence.
While the condition does not leave any permanent scar or pigmentary changes, skin tone
may take several months to return to normal.
A regimen of one tablet a month of ketoconazole, fluconazole, and itraconazole has been
used successfully to prevent recurrences

15. DIFFERENTIAL
DIAGNOSIS
06

16. Pityriasis alba
Pityriasis alba is a common disorder that is
characterized by an asymptomatic, hypopigmented,
slightly elevated, fine, scaling plaque with indistinct
borders.
The condition, which affects the face, lateral upper
arms , and thighs , appears in young children and
usually disappears by early adulthood.

17. Pityriasis Rosea
The typical eruption begins with the appearance of
one or multiple “herald patches”, which are large,
isolated, oval lesions, usually pink in color and
slightly scaly; they may occur anywhere on the body.
On occasion, the herald patch clears centrally,
mimicking tinea corporis.
From 5 to 10 days later, other smaller oval lesions
appear on the body, frequently concentrated over
the trunk but also seen on the proximal extremities,
especially the thighs

18. DIFFERENTIAL DIAGNOSIS
In adults, the white spots of tinea versicolor are most often Misdiagnosed as vitiligo . In
vitiligo, absence of scale and complete depigmentation are distinguishing factors from
tinea versicolor.
Tinea versicolor appearing as pink or tan scaling patches on the chest may be
misdiagnosed as seborrheic dermatitis . The distribution of seborrheic dermatitis involves
the hairline, eyebrows, nasolabial folds, and mid chest.

19. RESOURCES
● FITZPATRICK'S Dermatology in general medicine
● Ferri's Clinical advisor 2021
● Lookingbill and Marks' Principles of Dermatology, sixth edition
● Habif's Clinical Dermatology, Seventh Edition
● Zitelli and Davis' Atlas of Pediatric Physical Diagnosis, Seventh Edition