Presentation
· Multiple well-demarcated, scaly [on scraping surface], oval-to-round hypo or hyperpigmented macules that frequently coalesce into larger patches, slightly itchy
· DD – Pityriasis Alba [children, hypopigmented patches, unknown cause, self resolves]
Treatment
· Selenium sulphide suspension (2.5%) shampoo – Once a day, to affected area, leave it on for 15minutes and wash off. Use for 7 days.
· Ketoconazole 2% shampo – Use daily for 14 days.
· Limited patches – miconazole [Once a day for 3 weeks], terbinafine [Use twice daily for 7 days]
· Severe and systemic – Itraconazole 200 mg [One tablet a day for seven days]
· Avoid tanning & exposure to sunlight – will contrast areas
· Will take several months to fade after treatment – difficult to tell if treatment is successful until the patient acquires a tan in the following year.
Information sheet: http://www.patient.co.uk/health/pityriasis-versicolor-leaflet