Dermoscopy: An easy way to solve the diagnostic puzzle in pityriasis versicolor

Naveen Thomas, Subrata Malakar

 Rita Skin Foundation, Kolkata, West Bengal, India

Correspondence Address:
Subrata Malakar
Rita Skin Foundation, GD Block, Salt Lake City, Kolkata, West Bengal
India

A 28-year-old man, undergoing treatment for vitiligo, presented with complaints of new lesions on the neck for the last 1 week. On examination, multiple hypopigmented macules were seen on the neck [Figure - 1]. “Scratch sign” or “coup d'ongle sign” was negative on examination with naked eye.On examination with a dermoscope (Dermlite dl3 dermoscope, noncontact, polarizing, 10× magnification), very fine scales were present along the natural skin creases on a background of hypopigmented skin. Scaling was inconspicuous on the area between the skin creases. On stretching the skin these fine scales appeared more prominent under dermoscope but were still inconspicuous with naked eye [Figure - 2]. Potassium hydroxide (KOH) mount confirmed the diagnosis of pityriasis versicolor.

Figure 1: Patient with vitiligo (red arrow) showing multiple hypopigmented to depigmented macules (black arrows) on the neck

Figure 2: Dermoscopic picture showing fine scales along the skin markings with sparing of the skin between the markings

The dermoscopic feature of presence of fine scaling along the normal skin markings on a background of hypopigmented/hyperpigmented skin, giving it a “wire fence” appearance, may serve as a useful clue for easy and quick diagnosis of pityriasis versicolor [Figure - 3].

Figure 3: Magnified dermoscopic picture showing scales arranged along diamond-shaped skin markings giving a “wire fence” or “fish net appearance”

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.