Tinea Versicolor

Evaluation/Diagnostic Protocol

Subjective

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.