infectious

Tinea Versicolor (Pityriasis versicolor)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

BAD Guidelines for Tinea Versicolor 2014 · Nizoral 2% Shampoo SmPC section 4.2 (eMC product 1510) · Egyptian National Drug Formulary, antimicrobial 2023, selenium sulfide monograph, tinea versicolor

Verified against2 documents

Nizoral 2% Shampoo SmPC section 4.2 (eMC product 1510)
Egyptian National Drug Formulary, antimicrobial 2023, selenium sulfide monograph, tinea versicolor

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (1)

Lesions are usually painless or mildly itchy, though itching can become severe in hot, humid weather [itching]

Signs — what you find (7)

Lesions appear as multiple sharply bordered, oval, finely scaly patches that may be lighter, darker, or reddish, sometimes merging together [scaling]
Scale is often not obvious until the skin is stretched or scraped, which brings it out, known as the evoked scale sign
Lesions favor the upper trunk and upper arms, with facial involvement more common in children
An inverse form favors skin folds, the face, or isolated limb areas and is most common in immunocompromised patients
A follicular form on the back, torso, and limbs affects hair follicles, causing lighter or darker skin around them
A papular form shows uniform reddish-brown bumps about 2 to 3 mm across, usually painless and on the torso [papules]
A rare atrophying variant produces oval, reddish or ivory lesions with a wrinkled surface, often linked to prolonged topical steroid use

Tests (5)

Diagnosis can often be made from the characteristic appearance alone, without further testing
Dermoscopy typically shows fine scale and a contrast halo ring around the lesion
KOH microscopy gives a definitive diagnosis, showing grape-like clusters of yeast plus long hyphae
A stain such as methylene blue or ink blue can be added to the KOH prep to improve visibility since KOH alone lacks color contrast
Culturing the causative Malassezia yeast is difficult because it needs fastidious growth conditions

If not this — what else fits (11)

Seborrheic dermatitis tends to be more red with thicker scale and also involves the scalp, eyebrows, and nasolabial folds
Pityriasis rosea shows a collarette of scale in a fir-tree pattern on the trunk, usually preceded by a larger herald patch
Erythrasma affects the armpits or groin and glows coral-red under Wood's lamp, unlike tinea versicolor
Pityriasis alba does not fluoresce under Wood's lamp and mainly affects children with a history of atopic dermatitis
Secondary syphilis frequently involves the palms and soles, unlike tinea versicolor
Tinea corporis by definition spares the feet, groin, face, scalp hair, and beard hair
Vitiligo causes complete depigmentation, whereas tinea versicolor only causes partial lightening
Confluent and reticulated papillomatosis shows scaly hyperpigmented macules merging into a net-like pattern on the neck, between the breasts, or upper back
Guttate psoriasis produces small, inflamed, drop-shaped scaling plaques on the trunk and upper arms, often after a strep infection
Mycosis fungoides can present as hypopigmented patches on the trunk and limbs, most often in people with darker skin
Terra firma-forme dermatosis affects the neck or ankle and, unlike tinea versicolor, wipes off with an alcohol swab

SourceStatPearls "Tinea Versicolor" - disease-level clinical article

Presentation findings are traced to the source above.

KETOCONAZOLE

1st line

Formtopical

Adult dose and duration

Apply 2% shampoo once daily for 5 days (leave on 5 min before rinsing), or 2% cream 1-2 times daily for 2-3 weeks x 5 days (shampoo); 2-3 weeks (cream)

Paediatric dose

Dose by age
Children >=12 years:	apply shampoo once daily for 5 days

Dose source

Nizoral 2% Shampoo SmPC section 4.2 (eMC product 1510)

Why

Topical azole antifungal active against the lipophilic yeast Malassezia furfur that causes pityriasis versicolor; clears the causative organism, though the resulting skin discolouration takes months to normalise afterward.

Cautions

Caused by lipophilic yeast Malassezia furfur.
Inform patient that hypopigmented spots take months to normalize after yeast eradication.
Lather shampoo over entire chest/back and leave on for 5 minutes before washing off.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
KONAZOLE 2% CREAM 15 GM	ALFACURE PHARMACEUTICALS	6.00 EGP
CURAZOLE 2% TOPICAL CREAM 15 GM	EVA PHARMA	7.00 EGP
KETODERM 2% TOP. CREAM 20 GM	SEDICO	7.00 EGP
KONAZOLE 2% SHAMPOO 60 ML	ALFACURE PHARMACEUTICALS	12.00 EGP
KETODERM 2% GEL SHAMPOO 60 GM	SEDICO	18.00 EGP
WELLOFUNG 2% TOPICAL CREAM 40 GM	EGPI > HEALTH WELL	48.00 EGP
ZAKAN 2GM/100ML SHAMPOO 60 ML	SIGMA	18.30 EGP
NIZAPEX 20MG/GM SHAMPOO 80 ML	APEX PHARMA	68.00 EGP

SELENIUM SULFIDE

2nd line

Formtopical

Adult dose and duration

Apply 2.5% lotion to the affected skin with a little water, leave 10 minutes, then rinse thoroughly; once daily x 7 days

Paediatric dose

Not recommended in infants

Dose source

Egyptian National Drug Formulary, antimicrobial 2023, selenium sulfide monograph, tinea versicolor

Why

Antifungal and antiseborrhoeic lotion, an alternative to azole therapy for tinea versicolor that is particularly useful for widespread trunk involvement.

Cautions

Avoid contact with eyes, genital mucosa, and inflamed or broken skin.
Rinse off thoroughly after designated exposure to prevent skin irritation.
Selenium sulfide is an alternative topical antifungal and antiseborrheic agent for widespread trunk involvement.
Ten minutes, then wash it off. Leaving selenium sulfide on overnight is not a stronger course, it is a chemical burn waiting to happen.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
TINASEL 2.5 GM CREAM 20 GM	ALFACURE PHARMACEUTICALS	5.00 EGP
VENEER HAIR SHAMPOO 120 ML	EGYPTIAN COMPANY FOR COSMETICS > RAND PHARM	32.95 EGP
SELENO CARE HAIR SHAMPOO 150 ML	SIGMA > INTERPHARMA	98.00 EGP
SELENGENA ANTI-DANDRUFF SHAMPOO 120 ML	EGYPTIAN CO. FOR COSMETICS (E.C.C.) > PARKVILLE	105.00 EGP
SELENGENA ANTI-DANDRUFF SHAMPOO 220 ML	EGYPTIAN CO. FOR COSMETICS (E.C.C.) > PARKVILLE	165.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.