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

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.