Last Updated: 2013-11-28
A superficial fungal infection of the stratum corneum, due to dimorphic yeasts of the genus Malassezia, leading to hypo- or hyperpigmented macular lesions on seborrheic areas of the trunk.
Eruption is most common in the summer months in adolescents. Often has a relapsing nature requiring frequent treatment or prophylaxis.
Primarily a clinical diagnosis that is confirmed by a KOH preparation demonstrating fungal elements with a characteristic spaghetti-and-meatballs appearance indicating the presence of both yeast and short hyphae.
Easily treated with either topical medications, including zinc pyrithione shampoo, selenium sulfide shampoo, or azole-class topical antifungal creams. More extensive disease may require systemic therapy with antifungal drugs.
After successful treatment, patients should be reminded that it may take up to 6 weeks before their normal skin pigmentation returns.
Recurrence of the disease is common, and prophylactic treatment with selenium shampoo and, for more extensive disease, systemic therapy with antifungal drugs may be necessary.
Pityriasis versicolor in a light-skinned person
From the collection of Brian L. Swick, MD
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