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Systemic treatments provide better skin penetration than most topical preparations,

Itraconazole, terbinafine and griseofulvin are good choices for oral therapy.

Itraconazole and terbinafine are more effective than griseofulvin. Once-weekly dosing
with fluconazole is another option, especially in noncompliant patients.

Personal hygiene (foot hygiene) is highly advised.

3.7.5. Tinea versicolor (Pityriasis versicolor)

Versicolor versicolor is a common, benign, superficial cutaneous (stratum corneum)
fungal infection at the level of stratum corneum characterized by hypo pigmented or

hyperpigmented macules and patches with faint scale on the chest and the back.

Etiology: Malassezia furfur (Pityrosporon ovale,)

M furfur is a member of normal flora of the skin found in 18% of infants and 90-100%

of adults. Predisposing factors include - genetic predisposition, warm, humid

environments, excessive sweating, immunosuppression, malnutrition, and Cushing
disease.

Investigation

The clinical presentation of Pityriasis versicolor is distinctive, and the diagnosis is
made without potassium hydroxide (KOH) examination.

Treatment

Patients should be informed that it is caused by a normal flora of the skin hence it is

not transmitted and any skin color alterations resolve within 1-2 months after
treatment. Recurrence is common if the patient is not given enough dose of treatment..

Effective topical agents include: Sodium thiosulphate solution, selenium sulfide and
azole, ciclopiroxolamine, and allylamine antifungals.

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