Pityriasis Versicolor

Key Points
Common skin condition which affects the torso primarily, but also neck and arms
Associated with proliferation of Malassezia yeast on the affected skin
Consists of patches of skin which are flaky or scaly and discolored

Tinea versicolor, or pityriasis versicolor, is a common skin condition which usually affects the torso, but may also appear on the arms or neck. The condition consists of patches of skin which are flaky and discolored. Discoloration may range from orange-brown or pink, or in some cases may be darker or paler in comparison to surrounding healthy skin.

Tinea versicolor is caused by a proliferation of the Malassezia genus of yeast in the affected areas. These yeast, in normal concentrations, do not cause skin conditions, and form part of the flora that reside normally on the surface. The condition is less common in cold, dry climates, and more likely to affect persons who perspire heavily.

Differential Diagnosis (Other conditions with similar appearance)

Pityriasis alba
Psoriasis, Guttate
Seborrheic Dermatitis
Tinea Corporis
Vitiligo

Diagnosis
Key Points
Diagnosis based on the characteristic appearance, primarily in younger patients, teens to thirties
Scrapings of the surface scale may be performed by your doctor for direct microscopic visualization of the responsible organism to confirm the diagnosis

Treatment
Treatment typically consists of the administration of antiyeast medications, both topical and occasionally oral
Topical treatment course lasts approximately 3 weeks in most cases
Severe cases may require more aggressive systemic therapies, and recurrences are common

Treatment of tinea versicolor typically consists of the administration of antiyeast medications, either topically or orally. A topical course of antiyeast cream lasts approximately three weeks in most cases. In widespread or recalcitrant cases, systemic therapies, such as administration of oral ketoconazole may be recommended. Additionally, intermittent use of topical antiyeast creams or washes (such as OTC ketoconazole or selenium sulfide shampoo used as a body wash) may prevent frequent recurrences of the condition.