Spaghetti and meat ball appearance is seen in -
Ans is 'c' i.e., Pityriasis versicolor Pityriasis versicolor (tinea versicolor)o Tinea versicolor is a misnomer as it is not caused by a dermatophyte; it is caused by a nondermatophytic fungus called Pitvrosporum ovale (malasezia furfur}. Usually affects young adults.Clinical featureso There are multiple scaly hypopigmented (more common) or hyperpigmented macules. Scaling is fufuracious or rice powder like. Macules start around the hair follicles and they merge with each other to form large areas. Affects trunk and shoulders (mainly chest and back). There may be loosening of scales with fingernails- coupled onle or stroke of nail. Lesions are recurrent in nature.Diagnosis1. Examination of scales in 10% KOH shows short hyphae and round spores (sphagetti and meatball appearance). Wood's lamp show's apple green f!uorescence(blue-green fluorescnce).2. Skin surface biopsy - a cyanoacrylate adhesive is used to separate the layer of stratum comeum on glass slide and then stained writh PAS reagent.Treatment1. Systemic agentssystemic azoles provide convenient therapeutic option. Drugs used are ketokonazole, fluconazole or iatroconazole2. Topical antifungals used are -Azolesclotrimazole, econazole, miconazole, ketoconazoleOthers selenium sulphide, sodium thiosulphate, whitefield's ointment (3% salicylic acid + 6% benzoic acid).
Dermatophytes
Aspergillus
Pityriasis versicolor
Candida
Skin Lesions