PITYRIASIS VERSICOLOR

INVESTIGATIONS
Direct Microscopic Examination of Scales

Prepared with KOH - Scale is best obtained with two microscope slides, using one to raise scale and move it onto the other. -The harvested scale is moved into a small pile in the center of the slide and covered with a coverslip. -KOH solution (15 to 20%) is added at the edge of the coverslip; the slide is gently heated and examined. -Filamentous hyphae and globose yeast forms, termed spaghetti and meatballs, are seen.

 Woods Lamp

-Blue-green fluorescence of scales; may be negative in individuals who have showered recently because the fluorescent chemical is water soluble.

 Skin Surface Biopsy

-cyanoacrylate adhesive (crazy glue) used to remove a strip of superficial stratum corneum from the skin surface on a glass slide. - The slide is rolled off the skin after 20 seconds and then stained with periodic acid-Schiff reagent. -spores and pseudomycelium of Pityriasis versicolor seen.

TREATMENT
Topical imidazole creams (e.g. miconazole,

clotrimazole, econazole) applied once daily over 6 weeks ketoconazole shampoo to wash the affected areas once daily for 5 days 20 per cent sodium thiosulphate solution and selenium disulphide shampoo are also effective oral itraconazole (1200 mg/day) for 715 days.