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)

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

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"

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

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

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

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.