April 2018

  • Patient Information
    • 43 year old male presented with hyperpigmented, scaly patches on his lower back.
  • Clinical Diagnosis
    • Confluent and reticulated papillomatosis
    • Tinea versicolor
  • Histology

    Sections show acanthosis with hyperkeratosis. An accompanying  spare superficial chronic inflammatory infiltrate is also seen.

    Higher magnification reveals fungal hyphae and spores.

  • Final Diagnosis

    Tinea versicolor

    • Tinea versicolor is a common cutaneous fungal infection which may chronically recur
    • TV most frequently occurs in sub-tropical and tropical regions with high temperatures and high humidity
    • Patients present with hypopigmented or hyperpigmented macules and patches often on the back and chest
      • A fine scale is often seen
      • Lesions are usually asymptomatic but some lesions are itchy
    • Tinea versicolor is caused by a dimorphic, lipophilic fungus of the genus Malassezia, formerly known as Pityrosporum
    • Histopathology reveals fungal hyphae and spores (spaghetti and meatballs) within the stratum corneum
      • Associated hyperpigmentation and acanthosis can also be seen in some cases
    • Topical antifungal agents are the first line treatment of choice
  • Summary
    • Tinea versicolor is a common cutaneous fungal infection which may chronically recur
    • Patients present with scaly hypopigmented or hyperpigmented macules and patches often on the back and chest
    • Tinea versicolor is caused by a dimorphic fungus of the genus Malassezia, formerly known as Pityrosporum
    • Histopathology reveals fungal hyphae and spores (spaghetti and meatballs) within the stratum corneum
    • Topical antifungal agents are the first line treatment of choice