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Updated: May 29, 2025

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Beyond the Surface: Decoding Pityriasis Versicolor Through Clinical, Dermoscopic and Microbiological Exploration.

Priya A Dsouza1, Rochelle C Monteiro2, Meena Dias3

  • 1From the Department of Dermatology, Kasturba Medical College, Manipal, Karnataka, India.

Indian Journal of Dermatology
|February 3, 2025
PubMed
Summary

Dermoscopy effectively aids in diagnosing pityriasis versicolor (PV), a common fungal skin infection, by revealing specific visual patterns. This non-invasive method can serve as a valuable alternative or supplement to traditional potassium hydroxide (KOH) mounts.

Keywords:
Dermoscopyfungal culturepityriasis versicolor

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Area of Science:

  • Dermatology
  • Mycology
  • Medical Diagnostics

Background:

  • Pityriasis versicolor (PV) is a superficial fungal infection caused by Malassezia species, leading to skin discoloration and altered pigmentation.
  • Diagnosis is typically clinical, but dermoscopy offers an alternative for ambiguous cases when potassium hydroxide (KOH) mounts are unavailable.

Purpose of the Study:

  • To evaluate clinical and dermoscopic patterns in pityriasis versicolor.
  • To correlate these patterns with risk factors and fungal culture results.

Main Methods:

  • A 12-month cross-sectional observational study involved 115 patients with clinically diagnosed PV confirmed by KOH mount.
  • Dermoscopy was performed, followed by scale scraping for fungal culture on specialized media.
  • Results were analyzed after a 3-week incubation period.

Main Results:

  • Clinical evaluation revealed 79 achromic and 36 chromic lesions.
  • Dermoscopy showed fine scaling (88.7%) and non-uniform pigmentation in all patients.
  • Novel findings included 'barbed wire fence,' 'fluffy cotton ball,' and 'sprinkled pepper' appearances.
  • Fungal culture yielded growth in 51 (44.3%) cases, with Malassezia furfur being the most common isolate (18 patients).

Conclusions:

  • Dermoscopy is a valuable non-invasive diagnostic tool for PV, revealing characteristic features like scaling, pigment alteration, and perifollicular involvement.
  • It can be used as an adjunct or substitute for KOH mounts in diagnosing doubtful PV cases.