Pediatric Tinea Versicolor Follow-up

  • Author: Lyubomir A Dourmishev, MD, PhD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jun 6, 2011
 

Further Inpatient Care

No Inpatients Care is needed.

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Further Outpatient Care

  • Tinea versicolor tends to be associated with recurrences that must be properly treated.
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Inpatient & Outpatient Medications

  • Some authors recommend prophylactic with varying regimens of selenium sulfide shampoo or lotion.
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Transfer

  • Tinea versicolor is caused by M furfur, which is normally present on the skin surface and, therefore, is not considered a contagious disease.
  • In past contaminated clothes and underwear were believed to play a role in disease transfer; however, climate factors, hyperhidrosis, sebum secretion, and genetic factors appear to be involved in disease pathogenesis.
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Deterrence/Prevention

  • Tinea versicolor has a high recurrence rate and may require frequent prophylactic treatment with intermittent topical or oral therapy.
  • Good personal hygiene may help limit recurrences. Specifically, patients should shower as soon as possible after participating in activities or exercise that produce significant perspiration.
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Complications

  • The disease has benign course; however, it tends to have recurrences that must be properly treated. Some patients report for itching, burning and irritation of lesions.
  • Severe depigmentation may cause significant psychological discomfort.
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Prognosis

  • Prognosis is excellent.
  • Although tinea versicolor is recurrent in some patients, the condition remains treatable.
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Patient Education

  • Tinea versicolor is caused by a fungus that is normally present on the skin surface and, therefore, is not considered a contagious disease.
  • The disease causes no permanent sequelae, and any pigmentary alterations resolve entirely within a few months of adequate treatment.
  • Effective therapy is available. Recurrences are common, and prophylactic therapy may be required.
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Contributor Information and Disclosures
Author

Lyubomir A Dourmishev, MD, PhD  Assistant Professor, Department of Dermatology, Medical University, Alexander's University Hospital, Bulgaria

Lyubomir A Dourmishev, MD, PhD is a member of the following medical societies: European Academy of Dermatology and Venereology

Disclosure: Nothing to disclose.

Specialty Editor Board

Kevin P Connelly, DO  Clinical Assistant Professor, Department of Pediatrics, Division of General Pediatrics and Emergency Care, Virginia Commonwealth University School of Medicine; Medical Director, Paws for Health Pet Visitation Program of the Richmond SPCA; Pediatric Emergency Physician, Emergency Consultants Inc, Chippenham Medical Center

Kevin P Connelly, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Osteopathic Pediatricians, and American Osteopathic Association

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Robert A Schwartz, MD, MPH  Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi

Disclosure: Nothing to disclose.

Merrily P M Poth, MD  Professor, Department of Pediatrics and Neuroscience, Uniformed Services University of the Health Sciences

Merrily P M Poth, MD is a member of the following medical societies: American Academy of Pediatrics, Endocrine Society, and Lawson-Wilkins Pediatric Endocrine Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Department of Dermatology, Geisinger Medical Center

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

  1. Dourmishev AL. Pityriasis versicolor. In: Iliev B, Mitov G, Radev M. Infectology. Academic publishing house; 2001:812-3.

  2. Schmidt A. Malassezia furfur: a fungus belonging to the physiological skin flora and its relevance in skin disorders. Cutis. Jan 1997;59(1):21-4. [Medline].

  3. Nakabayashi A, Sei Y, Guillot J. Identification of Malassezia species isolated from patients with seborrhoeic dermatitis, atopic dermatitis, pityriasis versicolor and normal subjects. Med Mycol. Oct 2000;38(5):337-41. [Medline].

  4. [Guideline] Drake LA, Dinehart SM, Farmer ER, et al. Guidelines of care for superficial mycotic infections of the skin: Pityriasis (tinea) versicolor. Guidelines/Outcomes Committee. American Academy of Dermatology. J Am Acad Dermatol. Feb 1996;34(2 Pt 1):287-9. [Medline].

  5. Muhammad N, Kamal M, Islam T, Islam N, Shafiquzzaman M. A study to evaluate the efficacy and safety of oral fluconazole in the treatment of tinea versicolor. Mymensingh Med J. Jan 2009;18(1):31-5. [Medline].

  6. Ashbee HR, Evans EG. Immunology of diseases associated with Malassezia species. Clin Microbiol Rev. Jan 2002;15(1):21-57. [Medline]. [Full Text].

  7. Crespo Erchiga V, Ojeda Martos A, Vera Casano A, et al. Malassezia globosa as the causative agent of pityriasis versicolor. Br J Dermatol. Oct 2000;143(4):799-803. [Medline].

  8. Crowson AN, Magro CM. Atrophying tinea versicolor: a clinical and histological study of 12 patients. Int J Dermatol. Dec 2003;42(12):928-32. [Medline].

  9. Dehghan M, Akbari N, Alborzi N, Sadani S, Keshtkar AA. Single-dose oral fluconazole versus topical clotrimazole in patients with pityriasis versicolor: A double-blind randomized controlled trial. J Dermatol. Aug 2010;37(8):699-702. [Medline]. [Full Text].

  10. Di Silverio A, Zeccara C, Serra F, et al. Pityriasis versicolor in a newborn. Mycoses. May-Jun 1995;38(5-6):227-8. [Medline].

  11. Elewski BE. Cutaneous mycoses in children. Br J Dermatol. Jun 1996;134 Suppl 46:7-11: discussion 37-8. [Medline].

  12. Faergemann J, Hersle K, Nordin P. Pityriasis versicolor: clinical experience with Lamisil cream and Lamisil DermGel. Dermatology. 1997;194 Suppl 1:19-21. [Medline].

  13. Fernandez-Nava HD, Laya-Cuadra B, Tianco EA. Comparison of single dose 400 mg versus 10-day 200 mg daily dose ketoconazole in the treatment of tinea versicolor. Int J Dermatol. Jan 1997;36(1):64-6. [Medline].

  14. Gupta AK, Batra R, Bluhm R, Faergemann J. Pityriasis versicolor. Dermatol Clin. Jul 2003;21(3):413-29, v-vi. [Medline].

  15. Gupta AK, Batra R, Bluhm R, et al. Skin diseases associated with Malassezia species. J Am Acad Dermatol. Nov 2004;51(5):785-98. [Medline].

  16. Gupta AK, Bluhm R, Summerbell R. Pityriasis versicolor. J Eur Acad Dermatol Venereol. Jan 2002;16(1):19-33. [Medline].

  17. Gupta AK, Cooper EA, Ryder JE, et al. Optimal management of fungal infections of the skin, hair, and nails. Am J Clin Dermatol. 2004;5(4):225-37. [Medline].

  18. Gupta AK, Einarson TR, Summerbell RC, Shear NH. An overview of topical antifungal therapy in dermatomycoses. A North American perspective. Drugs. May 1998;55(5):645-74. [Medline].

  19. Gupta AK, Ryder JE, Nicol K, Cooper EA. Superficial fungal infections: an update on pityriasis versicolor, seborrheic dermatitis, tinea capitis, and onychomycosis. Clin Dermatol. Sep-Oct 2003;21(5):417-25. [Medline].

  20. Hickman JG. A double-blind, randomized, placebo-controlled evaluation of short-term treatment with oral itraconazole in patients with tinea versicolor. J Am Acad Dermatol. May 1996;34(5 Pt 1):785-7. [Medline].

  21. Hull CA, Johnson SM. A double-blind comparative study of sodium sulfacetamide lotion 10% versus selenium sulfide lotion 2.5% in the treatment of pityriasis (tinea) versicolor. Cutis. Jun 2004;73(6):425-9. [Medline].

  22. Janaki C, Sentamilselvi G, Janaki VR, Boopalraj JM. Unusual observations in the histology of Pityriasis versicolor. Mycopathologia. 1997;139(2):71-4. [Medline].

  23. Karakas M, Durdu M, Memisoglu HR. Oral fluconazole in the treatment of tinea versicolor. J Dermatol. Jan 2005;32(1):19-21. [Medline].

  24. Katsambas A, Rigopoulos D, Antoniou C, et al. Econazole 1% shampoo versus selenium in the treatment of tinea versicolor: a single-blind randomized clinical study. Int J Dermatol. Sep 1996;35(9):667-8. [Medline].

  25. Kaur I, Handa S, Kumar B. Tinea versicolor: involvement of unusual sites [letter]. Int J Dermatol. Aug 1996;35(8):604-5. [Medline].

  26. Kose O. Fluconazole versus itraconazole in the treatment of tinea versicolor. Int J Dermatol. Jul 1995;34(7):498-9. [Medline].

  27. Leeming JP, Sansom JE, Burton JL. Susceptibility of Malassezia furfur subgroups to terbinafine. Br J Dermatol. Nov 1997;137(5):764-7. [Medline].

  28. Mellen LA, Vallee J, Feldman SR, Fleischer AB Jr. Treatment of pityriasis versicolor in the United States. J Dermatolog Treat. Jun 2004;15(3):189-92. [Medline].

  29. Okuda C, Ito M, Naka W, et al. Pityriasis versicolor with a unique clinical appearance. Med Mycol. Oct 1998;36(5):331-4. [Medline].

  30. Partap R, Kaur I, Chakrabarti A, Kumar B. Single-dose fluconazole versus itraconazole in pityriasis versicolor. Dermatology. 2004;208(1):55-9. [Medline].

  31. Savin RC. Systemic ketoconazole in tinea versicolor: a double-blind evaluation and 1-year follow-up. J Am Acad Dermatol. May 1984;10(5 Pt 1):824-30. [Medline].

  32. Shi VS, Lio PA. Diagnosis of pityriasis versicolor in paediatrics: the evoked scale sign. Arch Dis Child. Apr 2011;96(4):392-3. [Medline].

  33. Silva V, Di Tilia C, Fischman O. Skin colonization by Malassezia furfur in healthy children up to 15 years old. Mycopathologia. 1995-96;132(3):143-5. [Medline].

  34. Silva V, Fischman O, de Camargo ZP. Humoral immune response to Malassezia furfur in patients with pityriasis versicolor and seborrheic dermatitis. Mycopathologia. 1997;139(2):79-85. [Medline].

  35. Sunenshine PJ, Schwartz RA, Janniger CK. Tinea versicolor: an update. Cutis. Feb 1998;61(2):65-8, 71-2. [Medline].

  36. Vermeer BJ, Staats CC. The efficacy of a topical application of terbinafine 1% solution in subjects with pityriasis versicolor: a placebo-controlled study. Dermatology. 1997;194 Suppl 1:22-4. [Medline].

 
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In patients with lighter skin color, lesions frequently are a light tan or salmon color.
Upon potassium hydroxide (KOH) examination, hyphae are visible and grow into strands within clumps of keratinocytes. Thick-walled spores frequently occur in grapelike clumps. Individual spores and short stubby hyphae float in the clear areas between clumps of keratinocytes. Many of the short hyphae are dystrophic.
Scale is frequently difficult to appreciate upon clinical examination.
This individual developed skin discoloration and mild itching every summer for the past few years. These patients should be instructed on the prophylactic use of topical therapy.
This superficial plaque of tinea versicolor is located in the right antecubital fossa of an adult. This appearance and distribution is uncommon but not rare. A potassium hydroxide (KOH) preparation confirmed the diagnosis.
Although tinea versicolor is uncommon in children in temperate climates, when it does occur, it is more likely to be atypical in distribution. This 7-year-old boy had areas of tinea versicolor across the forehead and both temples. He was in good health and lived in Washington state when he was diagnosed.
In some patients, the areas affected by tinea versicolor are not always obvious. In this patient, the abnormal areas are hypopigmented.
Clear adhesive tape can be pressed onto areas of tinea versicolor to collect hyphae and spores. The tape is then lightly pressed onto a glass slide, and a drop of methylene blue is placed at the edge of the tape. The methylene blue is allowed to run under the tape staining Malassezia furfur. The spores and hyphae easily are seen against a background clutter of keratinocytes and glue.
Some patients present with extensive tinea versicolor. This patient related that his discoloration had been present for more than 20 years. The light-colored areas on the abdomen are the normal areas of skin. Although topical therapy alone is usually effective, this patient may benefit from initial therapy with oral ketoconazole, followed by selenium sulfide applications in the shower 2-3 times a month.
Significant hyperpigmentation caused by a tinea versicolor infection.
Confluent and reticulated Gougerot and Carteaud papillomatosis.
Mycelium strands and numerous spores observed on a potassium hydroxide (KOH) preparation of tinea versicolor. This combination is commonly referred to as "spaghetti and meatballs."
 
 
 
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