Atrophying Pityriasis Versicolor ( 2 фото )

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A 30-year-old man presented to the dermatology clinic with a 6-month history of depressed skin lesions on his back. The lesions had previously been diagnosed as scars, but the patient had no history of acne, trauma, or burns to the back. On physical examination, numerous well-defined, erythematous, atrophic plaques were noted across the back (Panel A). A fluorescence staining preparation of skin scrapings showed thick fungal hyphae and yeast cells with a “spaghetti and meatballs” pattern — a finding consistent with malassezia infection (Panel B; enzyme-linked fluorescence staining). A diagnosis of atrophying pityriasis versicolor was made. Pityriasis versicolor is a dermatosis caused by commensal fungal organisms in the genus malassezia. The condition is also called tinea versicolor, though it is not a dermatophyte infection like tinea corporis or tinea pedis. Pityriasis versicolor typically manifests as hyperpigmented or hypopigmented macules on the trunk. The lesions may also be erythematous or, in rare cases, atrophic, as in this case. After a 1-week course of itraconazole, the rash resolved (Panel C).

Authors: Jiawen Chen, M.D., and Chao Ji, M.D., Ph.D.
Published November 13, 2024
N Engl J Med 2024;391: e42
DOI: 10.1056/NEJMicm2405351
VOL. 391 NO. 19


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