Pityriasis Versicolor in Babies and Children

Pityriasis versicolor in babies and children is a benign, non-contagious skin condition that occurs quite frequently. Learn more.

Written and verified by the dermatologist Maria del Carmen Hernandez.

Last update: 10 May, 2023

Pityriasis versicolor in babies and children is a condition frequently seen in the doctor’s office. Although it’s a disease that’s not contagious, it must be solved quickly to avoid complications. It’s characterized by spots on different parts of the body generated by a fungus that’s specific to the skin. Are you interested in knowing more about it? Keep reading to learn more about this disease.

Why does pityriasis versicolor in babies and children occur?

Also known as tinea versicolor, it’s a common, benign, superficial, fungal infection of the skin. In fact, the fungus is a normal component of the skin flora. Some of the species associated with the disease are Malassezia furfur, Malassezia globosa, and Malassezia sympodialis. Although it can occur anywhere in the world, it’s more likely to develop in humid or warm climates.

Some of the situations that may predispose individuals to this type of infectious condition are the following:

• Genetic predisposition
• Environmental conditions such as heat and humidity
• Immunodeficiencies
• Oily skin
• Pregnancy
• Chronic use of oily lotions and creams

Clinical manifestations of pityriasis versicolor

The clinical features of pityriasis versicolor in babies and children include patches that are thinly scaling, hyperpigmented, or hypopigmented. In addition, the most frequent locations are the neck, trunk, and proximal extremities. In other words, it affects with greater predisposition the most seborrheic areas such as the face, scalp, back, and nape of the neck. This is evidenced by multiple well-defined plaques or patches.

The different variants of the lesions may be as follows:

• Hypopigmented.
• Hyperpigmented
• Erythematous
• Confluent
• Disseminated

Skin lesions tend to be asymptomatic or present only mild pruritus. However, severe pruritus may occur in warm, humid conditions and may be the only symptom that needs to be treated.

Differential diagnoses

The clinical manifestations of pityriasis versicolor in infants and children are often similar to the symptoms and signs of various diseases. Therefore, it may lead to confusion with the following conditions:

• Tinea corporis
• Pityriasis rosea
• Seborrheic dermatitis
• Pityriasis alba
• Vitiligo
• Nummular eczema
• Guttate psoriasis

Pityriasis versicolor can affect all social strata equally and is distributed worldwide. Dermatologists can even make an accurate diagnosis by simply observing the lesions on the skin.

Therapeutic options for pityriasis versicolor

The diagnosis of the disease is usually made only on clinical grounds. The treatment required is long-term maintenance due to the high recurrence rate. It’s usually treated effectively with topical and/or systemic agents.

Topical medication

As for topical drugs, they’re considered the first-line therapy for pityriasis versicolor. This type of therapeutic option can be divided into two variants:

• Nonspecific microbial agents: Selenium sulfide, sulfur plus salicylic acid, and zinc pyrithione. These are responsible for eliminating dead tissue and preventing dissemination.
• Specific antifungal drugs: Have fungicidal or fungistatic effects. These include imidazoles (ketoconazole, clotrimazole, econazole, and isoconazole), ciclopirox olamine and allylamine (terbinafine).

Ketoconazole is the most commonly used topical drug for the treatment of pityriasis versicolor. Topical procedures usually require a duration of about 1 to 4 weeks.

Oral medication

This type of therapeutic option is considered the second line of treatment. It’s applied in cases where clinical manifestations are generalized, recalcitrant, recurrent, or severe.

Oral medications include itraconazole and fluconazole, which are two drugs that are preferred to oral ketoconazole. The latter is disapproved because of hepatotoxic adverse effects, according to publications in The Journal of Family Practice. Oral terbinafine is another commonly prescribed medication, but it’s not a very effective treatment.

A common and benign disease

Pityriasis versicolor is benign and isn’t a contagious condition, as the causative agent is a commensal fungus of normal skin. Although topical and oral antifungal medication is effective, recurrence of the disease is quite common and can affect the child’s quality of life.