FOLLICULOCENTRI ANNISA KAMILAH

C TINEA 03012027
24 JULI 26 AGUSTUS
2017

VERSICOLOR
ABSTRACT
Abstract Tinea versicolor (TV) is typically an
asymptomatic fungal infection of the
stratum corneum owing to Malassezia
overgrowth. It presents as hypoor
hyperpigmented macules with fine scale
that coalesce into patches on the trunk,
neck, and/or arms. Presented in this report
is a 34-year-old man with an interesting
case of folliculocentric tinea versicolor
manifesting as perifollicular hypopigmented
macules on the lower back.
INTRODUCTION
Tinea versicolor is caused by Malassezia;
-M. globosa
-M. furfur
Seborrheic area the hair infundibula within sebaceous areas contains
sebum that is needed by Malassezia yeasts
Hypopigmented skin lesions pathogenesis:
1. Azaleic acid produced by Malassezia
2. The thickened scale of the stratum corneum
Factors involved in TV :
1. A possible genetic predisposition (21%)
2. heat, humidity, excessive perspiration, Cushing syndrome, long-term
immunosuppressive corticosteroid use, pregnancy, diabetes mellitus,
and poor nutrition
CASE SYNOPSIS
Physical Examination:
A 34 years old man hypopigmented
perifollicular macules
Asymptomatic
on the lower back
hypopigmented spots
hypopigmented
(back and chest) had
patches on the mid and
been present for years
upper back, chest, and
arms (Figure 1)
Woods Lamp
History: negative
No DM Biopsy Budding
Family Vitiligo yeast and hyphae in
No treatment involved stratum corneum
(Figure 2)
FIGURE 1
FIGURE 2
CASE DISCUSSION
Tinea versicolor typically manifests:
Hypopigmented macules
Hyperpigmented macules
Scale
Microscopic examination of skin scrapings with KOH
short hyphae and yeast forms reminiscent of ziti and
meatballs in the stratum corneum with minimal
inflammation
Woods lamp positive if yellow fluorescence is
present (50%)
Various clinical presentations of TV:
hypopigmented, hyperpigmented, combination hyper-
and hypopigmented, erythematous, circinate, acral,
and atrophic variants
Cases of folliculocentric tinea versicolor have been
rarely mentioned in the literature;
It is an uncommon manifestation of Tinea Versicolor
Initially presents as small folliculocentric macules
larger hypopigmented macules and patches where
the folliculocentric quality is lost
It has been seen in immunocompromised transplant
patients
Recently found an increase in hair loss within tinea
versicolor lesions
 Tinea Progressiv Vitiligo Pityriasis
Versicol e Macular Alba
or Hypomelan
osis

Hypopigmenta + asymptomat With +

tion ic perifollicul
ar
retention
of pigment

Scale + - + Only
superficial
scale

Affects
children
Malassezia overgrowth affecting hair
follicles pityrosporum folliculitis
Pityrosporum folliculitis manifests as
erythematous, often pruritic, follicular
papules on the upper trunk
Papule scrapings of pityrosporum
folliculitis budding yeast with an
absence of hyphae
Hypopigmentation could be an adjunct
criterion for tinea versicolor may not
be apparent in the centers of larger
coalesced lesions the periphery of
the lesions
CONCLUSION
Tinea versicolor as differential diagnosis
patients present with perifollicular
hypopigmented or hyperpigmented macules
Scaling of the skin suggest tinea versicolor
When there is no obvious scale, the evoked
scale sign could be helpful to guide the
diagnosis
Dermatology Online Journal.
Andrew Hudson, Bryan Carroll MD, Soo Jung Kim MD
Volume 23 Number 2 | February 2017 DOJ 23 (2): 6