1. Tinea versicolor caused by the yeast Malassezia furfur
the majority of pityriasis versicolor is caused by Malassezia globosa
normally found on the human skin
Usually during warm and humid environment
Not contagious (normal flora)

2. Symptoms
Generally oval or irregularly-shaped spots of 1/4 to 1 inch (0.6 to 2.5 cm) in diameter, often merging together to form a larger patch
Occasional fine scaling of the skin producing a very superficial ash-like scale
Pale, dark tan, or pink in color, with a reddish undertone that can darken when the patient is overheated, such as in a hot shower or during/after exercise
Sharp border
Sometimes severe "pin-prick" itching in the affected areas; usually when the person's body temperature is elevated by exercise or a hot/warm environment, but the person hasn't started sweating yet. Once sweating begins the "pin-prick" itching stops

3. Appear on the oily parts of the upper body, usually on the chest, back, and upper arms. The spots are flat and may be white, pink, red, tan, or brown..
In people with dark skin tones, pigmentary changes such as hypopigmentation are common, while in those with lighter skin color, hyperpigmentation are more common. These discolorations have led to the term "sun fungus"

4. Diagnosis Inspection of the spots
Examine a scraping of the infected skin under a microscope (KOH preparation)
Spagetti and meatballs apperance

5. Patient
multiple pruritic slightly erythematous with hyperpigmented patches
lower abdomen, inguinals and buttocks
2 months duration
patches are well-demarcated
with papules, vesicles, scales and excoriarion at the borders
Tinea Versicolor
oval or irregularly-shaped spots 0.6 to 2.5 cm in diameter, may merge to form patch
chest, back, and upper arms
Sharp border

6. Treatment Topical antifungal medications
.5% selenium sulfide (Shampoo)
Ciclopirox (Ciclopirox olamine) alternative treatment to ketoconazole as it suppresses growth of the yeast Malassezia furfur
Oral antifungal medications
400 mg ketoconazole or fluconazole in a single dose, or ketoconazole 200 mg daily for 7 days,
Itraconazole 400 mg daily for 3–7 days.
more effective by exercise 1–2 hours after the dose, to induce sweating. The sweat is allowed to evaporate, and showering is delayed for a day, leaving a film of the medication on the skin

7. Recurrence
Often recurs after treatment, but usually not right away, so that treatment needs to be repeated only every year or two.
Patches that are brown or reddish-brown resolve quickly
Spots that are lighter than the surrounding skin take several months for overall color to even out.
Tinea versicolor does not leave permanent skin discoloration.