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Pityriasis Veriscolor

Introduction

Pityriasis veriscolor is a type of fungal skin infection. It is typically very superficial, and is caused by the Malassezia group of fungus. It is often asymptomatic, except for a flaky appearance of the skin, often with pale white, brown or pink coloured patches. It may persist for months or even years.

It differs from the other main types of fungal skin infection tinea and candida as it is caused by a different type of fungus. Tinea is caused by dermatophytes (“ringworm”), candida by … candida(!) whilst pityriasis veriscolor is caused by malassezia. 

Pityriasis versicolor is more common in hot, humid climates, and in those who sweat heavily.

Pityriasis versicolor – note the white circular affected patches of skin. Image from Dermnet. Used in accordance with Creative Commons Attribution-NonCommercial-NoDerivs 3.0 (New Zealand) license.

Clinical Features

Differential Diagnosis

Pathology

Diagnosis

May be diagnosed clinically, but ideally should be confirmed with skin scrapings.

Management

Usually, topical agents are applied for about 2 weeks. The scaling of the skin will typically resolve quite quickly, but it can be several months until the colour of the skin returns to normal.

The “-azoles” (e.g. fluconazole, ketaconazole) are the anti-fungal drugs that are effective against malassezia.

Topical treatments include:

Advise patients to wash with an anti-dandruff shampoo at least twice a week in future to reduce the risk of recurrence.

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