Dermoscopy- a useful tool for diagnosis of Pityriasis Versicolor

Pityriasis versicolor is a superficial fungal infection of the skin. It is caused by Malassezia, a lipophilic dimorphic fungus. This fungus is part of the normal skin flora but can cause disease when it converts to its pathogenic hyphal form. Certain genetics and environmental factors play a role in the same. Clinically, these patients present with varied color patches which are usually covered with fine scales in seborrehic area distribution. Close differential diagnosis of tinea versicolor is confluent and reticulated papillomatosis , seborrheic dermatitis, erythrasma. Treatment line of all these conditions is different from pityriasis versicolor, hence differentiation is required. Scales over the lesions are very fine, making it difficult to examine with naked eyes, hence scraping and biopsy is usually used for confirmation of the diagnosis. Scraping of the lesions yields scales which can be mounted on microscope and fungal elements if present can be appreciated. But for confirmation biopsy with PAS stain is to be done which shows characteristic, “spaghetti and meatball†appearance.

Dermoscopy is a non-invasive tool which shows submacroscopic features of various dermatoses. It has been traditionally used in the diagnosis of melanoma is Western population. Use of dermoscopy in general dermatology practice is recently being employed. There is only one case report regarding dermoscopic features of versicolor in literature. No study has yet been published illustrating the dermoscopic features of various types of tinea versicolor. Hence, we want to carry out this study to look for a non-invasive technique to diagnose versicolor which can be done by the physician himself, bedside, within a span of few minutes.

 References –

1.       Pedrosa AF, Lisboa C, Goncalves RA. Malassezia infections: a medical conundrum. J Am Acad Dermatol. 2014;71:170-176.

2.       Renati S, Cukras A, Bigby M. Pityriasis versicolor. BMJ. 2015;350: 1394.