Pityriasis versicolor

Latest update 29/06/10

Introduction

• A common infection of the skin caused the yeast Pityrosporum ovale

Key diagnostic features

• Symptoms – can be slightly itchy
• Distribution – upper trunk. Lesions frequently spread to the neck, upper arms and abdomen, and sometimes other sites
• Appearance of lesions
  • Individual lesions often oval shaped but large confluent areas frequently develop
  • Fawn coloured in light skin, lighter colour in dark skin
  • Fine scale
  • Woods lamp – pale yellow fluorescence

Management

• Provide a patient information leaflet
• Nizoral ® (ketoconazole) shampoo – make into a lather and leave on the skin for 10 minutes before washing off. Four treatments should be used per week for two weeks
• In widespread or resistant cases use Sporanox ® (Itraconazole) 200 mg daily for 7 days
• Once the yeast has been eradicated the scale will disappear, however warn the patients that it will take several months for the skin colour to returns to its original state
• Note: Lamisil ® (Terbinafine) is active against dermatophytes e.g. tinea, but has little effect on yeast infections

	Figure 1 - Pityriasis versicolor Fawn depigmentation in light skin
	Figure 2 - Pityriasis versicolor Lighter pigmentation in dark skin
	Figure 3 - Confluent patches of pityriasis versicolor
	Figure 4 - Close up of figure 3
	Figure 5 - Same patient as figure 3