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Tinea

Tinea versicolor (or pityriasis versicolor) is a common yeast infection of the skin, in which flaky discolored patches appear on the neck, chest, arms, and back. It commonly affects adolescents and young adults, and is more common in males. It is seen more commonly in hot and humid climates, and often affects people that perspire heavily; it may clear in the winter months and recur each summer. Affected patches appear lighter than the surrounding skin because the fungus prevents the skin from tanning.

Diagnosis

Tinea versicolor is usually diagnosed clinically. However the following tests may be useful:

  • Wood’s lamp (black light) examination: yellow-green fluorescence may be observed in affected areas
  • Microscopy using potassium hydroxide (KOH) to examine skin cells: hyphae and yeast cells that resemble "spaghetti and meatballs" are observed
  • Fungal culture: usually reported to be negative, as it is quite difficult for yeasts to grow in a lab
  • Skin biopsy: fungal elements may be seen within the outer layers of the skin (stratum corneum); special stains may be required

Treatment

Antifungal medications remain the mainstay of treatment. In most cases, topical antifungals are effective enough to clear infections. In severe cases, or when topical agents have failed, oral antifungal medications may be prescribed. Vigorous exercise/sweat production an hour after taking oral antifungals helps the the medication reach the skin surface, where it can effectively eradicate the fungus. Bathing/showering should be avoided for a few hours after ingestion of oral meds.

Tinea versicolor generally clears with treatment, but often recurs when conditions are right for fungus to proliferate. In those with frequent recurrences, anti fungal shampoos and lotions may be recommended twice weekly to reduce the number and severity of flares.

Occasionally white spots persist long after the scaling and yeasts have gone, despite exposure to the sun. In such cases, further antifugnal treatment is unhelpful.

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Sheth Dermatology& Mohs Surgery Center

9131 West 151st Street
Orland Park, IL 60462

(708) 323 DERM (3376)

(708) 390-0842