History: Where—What area of the body affected, chest, neck, upper arms, face, scalp, groin, and back?; How long—days, weeks, months, years? Symptoms—pruritic, painful, bleed; Quality—red, puffy, scaling, uneven skin color (hypopigmentation), small and scaly white to pink to tan papules/macules?; Severity—good/bad day? Mod. Factors—previous treatment? Context—associations? Timing—when does it occur?
Objective: Complete skin exam. Lesions are located mainly on the upper trunk; consist of small, large or confluent patches which shed a fine scale when scratched lightly. Multiple oval to round polycyclic patches or thin plaques. Seborrheic areas and upper trunk and shoulders—common; Less common face (more in kids), scalp, antecubital fossae, and groin; when involved in flexural area, it is sometimes called “inverse pityriasis versicolor’. Tan (hypopigmented) and brown (hyperpigmented) patches.