PITYRIASIS VESICULARIS.pptx

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1. TINEA (PITYRIASIS) VERSICOLOR Nuni Sulastri

2. TABLE OF CONTENTS DEFINITION 01 EPIDEMIOLOGY 02 ETIOLOGY AND PATHOGENESIS 03 CLINICAL FINDINGS AND LAB.TEST 04 PREVENTION 05

3. Tinea versicolor is a fungal infection of the skin caused by the yeast Pityrosporum orbiculare (Malassezia furfur), a commensal lipophilic fungus that lives in the hair follicles and stratum corneum. 01. DEFINITION

4. The infection occurs more frequently in regions with higher temperatures and relative humidity Incidence of tinea versicolor is the same in all races, but the eruption is often more apparent in darkerskinned individuals due to resulting alteration in skin pigmentation No sex predominance is apparent. Tinea versicolor is most common among adolescents and young adults, in whom lipid-producing sebaceous glands are more active. 02. EPIDEMIOLOGY

5. ETIOLOGY AND PATHOGENESIS 3

6. ETIOLOGY The infection is caused by Malassezia species (M. globosa, M. restricta, M. sympodialis, M. furfur, M. obtusa, and M. slooffiae).

7. PATHOGENESIS

8. CLINICAL FINDINGS AND LABORATORY TEST 4

9. Clinical Findings The typical presentation of tinea versicolor is scaly oval to round macules scattered over characteristic areas of the body, including the upper trunk, neck, and upper arms . The macules often coalesce forming irregular shaped patches of pigmentary alteration. The color of patches varies from almost white to pink to reddish brown or fawn colored

10. Clinical Findings Patches may have a wrinkled surface appearance and this feature serves as a useful clinical pearl for the diagnosis

11. DIAGNOSIS The diagnosis made on clinical grounds is supported by Wood ' s light examination which may show yellow–orange fluorescence thought to be due to the presence of pteridine and is confirmed by microscopic KOH examination of the scale.

12. LAB.TEST Potassium hydroxide (KOH) preparation of skin scrapings demonstrates the characteristic fungal spores and short cigar-butt hyphae (“spaghetti and meatballs”) Visualization of fungal elements may be enhanced by the addition of methylene blue stain to the KOH preparation Culture is rarely necessary and requires a lipid-containing medium (i.e., olive oil) to demonstrate growth.

13. PREVENTION 5 Recurrence is common and regular maintenance application of any of the topical agents helps to reduce high rates of recurrence. While the condition does not leave any permanent scar or pigmentary changes, skin tone may take several months to return to normal. A regimen of one tablet a month of ketoconazole, fluconazole, and itraconazole has been used successfully to prevent recurrences

14. DIFFERENTIAL DIAGNOSIS 6

15. Pityriasis alba Pityriasis alba is a common disorder that is characterized by an asymptomatic, hypopigmented, slightly elevated, fine, scaling plaque with indistinct borders . The condition, which affects the face, lateral upper arms , and thighs , appears in young children and usually disappears by early adulthood.

16. Pityriasis Rosea The typical eruption begins with the appearance of one or multiple “herald patches ” , which are large, isolated, oval lesions, usually pink in color and slightly scaly; they may occur anywhere on the body. On occasion, the herald patch clears centrally, mimicking tinea corporis. From 5 to 10 days later, other smaller oval lesions appear on the body, frequently concentrated over the trunk but also seen on the proximal extremities, especially the thighs

17. DIFFERENTIAL DIAGNOSIS In adults, the white spots of tinea versicolor are most often Misdiagnosed as vitiligo . In vitiligo, absence of scale and complete depigmentation are distinguishing factors from tinea versicolor . Tinea versicolor appearing as pink or tan scaling patches on the chest may be misdiagnosed as seborrheic dermatitis . The distribution of seborrheic dermatitis involves the hairline, eyebrows, nasolabial folds, and mid chest.

18. RESOURCES FITZPATRICK'S Dermatology in general medicine Ferri's Clinical advisor 2021 Lookingbill and Marks' Principles of Dermatology, sixth edition Habif's Clinical Dermatology, Seventh Edition Zitelli and Davis' Atlas of Pediatric Physical Diagnosis, Seventh Edition