Tinea versicolor

K Pavithran

 Department of Dermato-Venereology, A1alabar Institute of Medical Sciences, Calicut, India

Correspondence Address:
K Pavithran
Department of Dermato-Venereology, A1alabar Institute of Medical Sciences, Calicut
India

Tinea versicolor caused by Malassezia furfur (Pityrosporum orbiculare) continues to be a therapeutic challenge. As its name suggests it is often hypopigmented or coloured brown, pink or black and the scales are fine and branny. Diagnosis depends on demonstration of clusters of spores and short hyphae in KOH mounts of skin scrapings.

Localised lesions respond to common topical antifungals such as whitfield′s ointment, 1% miconazole or 1% clotrimazole. Extensive lesions may require shampoo containing 2.5% selenium sulphide. It is applied as follows:

Take 60ml of water in a plastic bucket and add 2-3 ml of shampoo in it and stir well. The lather that comes out is to be applied below neck all over the body and wash off after 30 minutes. At night he can apply topical 1% clotrimazole and then apply dusting powder containing clotrimazole or combination of acid salicylic 3% and acid benzoic 6%. The whole treatment is to be continued daily for 7 days, then alternate days for 2 weeks and then once in a week for 6 months to one year.

For florid lesions or those cases that do not respond to above described treatment may require systemic treatment. Fluconazole is commonly used. It is given 300 mg orally as single dose or 300 mg repeated in 3 weeks. Oral itraconazole 200 mg daily for 5 days or 100 mg daily for 10 days is another alternative. But it is more expensive than fluconazole.

Selenium sulfide shampoo is to applied on the scalp for those having associated seborrhoeic dermatitis.