From the Research
Pityriasis versicolor is a common fungal skin infection characterized by distinctive patches that may appear lighter or darker than surrounding skin, typically presenting as oval or irregularly shaped macules with fine scaling, and is caused by an overgrowth of Malassezia yeast, a normal component of skin flora that becomes problematic under certain conditions. The rash commonly appears on the chest, back, neck, and upper arms—areas with higher concentrations of sebaceous glands. The color varies from hypopigmented (lighter than normal skin) in darker-skinned individuals to hyperpigmented (tan to brown) or salmon-colored in lighter-skinned people 1.
The condition is usually asymptomatic, though some patients report mild itching, especially when sweating. The diagnosis can often be confirmed by examining the affected skin under a Wood's lamp, which causes the infected areas to fluoresce with a yellow-green color. Unlike many other rashes, pityriasis versicolor doesn't typically cause inflammation or significant discomfort, which helps distinguish it from conditions like tinea corporis or eczema. Key characteristics of the rash include:
- Oval or irregularly shaped macules
- Fine scaling that can be subtle or more prominent when the skin is stretched
- Hypopigmented or hyperpigmented patches
- Typically appears on the chest, back, neck, and upper arms
The most recent and highest quality study on the topic, published in 2023, provides a comprehensive overview of the diagnosis and management of pityriasis versicolor, highlighting the importance of recognizing characteristic clinical features and using diagnostic techniques such as microscopy, conventional and ultraviolet-induced fluorescence dermatoscopy, and confocal microscopy 1. Topical therapies, including non-specific antifungal agents and specific topical antifungal medications, are the primary treatment for PV, with systemic therapies used occasionally. Patient education and the promotion of good personal hygiene are pivotal to reduce the risk of recurrence, and in recurrent cases, prolonged prophylaxis with topical agents should be considered 1.