Pityriasis Versicolor

Patients often report patchy skin discoloration with pale (hypopigmented) or darker (hyperpigmented) areas, particularly on the upper body. They may mention mild itching, especially in warm, humid conditions. Recurrences are common in tropical climates, with complaints often intensifying during summer or after sweating. 

On examination, tinea versicolor presents as small, round or oval patches of discolored skin with fine scales, often on the trunk, back, and shoulders. These lesions may coalesce into larger areas and are more visible on sun-exposed skin, particularly on darker skin tones. 

Topical Treatments: First-line treatments include antifungal agents such as selenium sulfide 2.5% lotion, ketoconazole 2% shampoo, or clotrimazole 1% cream, applied daily for 1-2 weeks. Patients should be advised to leave these on for about 10-15 minutes before rinsing to maximize efficacy.

Oral Treatments: In cases of widespread infection or frequent recurrence, oral antifungals like fluconazole or itraconazole may be used. Fluconazole 300 mg as a single dose or itraconazole 200 mg daily for 5-7 days can be effective.

Preventive Maintenance: Monthly topical antifungal application (e.g., selenium sulfide) can prevent recurrences in susceptible individuals. Emphasizing hygiene, drying the skin properly, and avoiding excessive heat can reduce recurrence risk.