Diseases

It is relatively simple procedure to confirm this diagnosis. A drop of potassium hydroxide is applied to a small scraping of involved skin which is then examined under the microscope. The penne-and-meatball forms can be seen and confirm the diagnosis.

Since the organism that causes tinea versicolor is a normal inhabitant of the skin and the disease does not affect the patient's general health, there is no widely accepted approach to prevention.

Tinea versicolor is caused by yeast called Malassezia that normally lives on the skin of most adults without producing a disease. It exists in two forms, a yeast form and a form that resembles "penne and meatballs" when viewed microscopically. This second is presumed to produce the patches of discolored slightly scaly skin called tinea versicolor. Currently, it is believed that a chemical produced by Malassezia, azelaic acid, is responsible for the loss of pigment. Most people with this condition are perfectly healthy.Because the tinea versicolor fungus is part of the normal adult skin flora, this condition is not contagious. It often recurs after treatment, but usually not right away, so that treatment may need to be repeated only every year or two.

As noted above, the white spots of tinea versicolor tends to linger even after successful treatment. This persistent discoloration often leads people to think that the condition is still present long after it has been eradicated. It may take months for skin color to blend and look normal, but it always does. The red or brown variety of rash, on the other hand, clears up much sooner. It is, therefore, a good idea to have the condition treated as soon as new spots appear so that any discoloration lasts as short a time as possible.Recurrence of the rash is common, though it won't recur necessarily every year. Applying selenium sulfide or ketoconazole shampoo on affected areas once a week may slow the onset of recurrence but is cumbersome and often not worth the effort, since the condition may not come back for a long time anyway.

There are many antifungal agents available to apply to the skin for the treatment of tinea versicolor. Over-the-counter (OTC) remedies include clotrimazole (Lotrimin, Mycelex) and miconazole (Lotrimin). These should be applied twice a day for 10-14 days but come in small tubes and are hard to apply to large areas. Another OTC option is selenium sulfide shampoo 1% (Selsun Blue) or 1% ketoconazole shampoo (Nizoral). Some doctors recommend applying these for 15 minutes twice a week for two to four weeks.There are also many prescription-strength antifungal creams that can treat tinea versicolor, as well as a stronger form of selenium sulfide (2.5%) and prescription-strength ketoconazole shampoo (2%). However, these pose the same application problems as their OTC counterparts.Oral treatment for tinea versicolor has the advantage of simplicity. Two doses of fluconazole (Diflucan) or itraconazole (Sporanox) prescribed by your doctor can clear most cases of this infection. Some common medications such as alprazolam (Xanax) and montelukast (Singulair) may interact with fluconazole, so your doctor will need to know what other medications are being taken before treating tinea versicolor orally.

Tinea versicolor is a common fungal infection of the skin that often affects adolescents and young adults. The term versicolor refers to the fact that it frequently alters the color of involved skin. The most common areas it affects are the shoulders, back, and chest. At times, it can affect folds of skin, such as the crook of the arm, the skin under the breasts, or the groin. The face is usually spared, although this is not always true for children. Careful examination of the affected areas will reveal a slight increase in superficial scale. The disease rarely produces any symptoms.

The following conditions are sometimes indistinguishable from tinea versicolor on simple inspection:

• Pityriasis alba: This is a mild form of eczema (seen in young people) that produces mild, patchy lightening of the face, shoulders, or torso.
• Vitiligo: This condition results in a permanent loss of pigment. Vitiligo is more likely to affect the skin around the eyes and lips or the knuckles and joints. Spots are porcelain white and, unlike those of tinea versicolor, are permanent without therapy.