What are these hypopigmented patches?

Dermclinic

A 30-year-old man has had asymptomatic light-colored areas on his right shoulder for 3 to 4 weeks. The patient is an amateur bodybuilder; he is otherwise healthy and takes no medications.

Can you identify these hypopigmented areas?

A. Tinea versicolor.

B. Pityriasis alba.

C. Vitiligo.

D. Psoriasis.

E. Pityriasis rosea.

(Answer and discussion on next page)

ANSWER—Tinea versicolor

The round and oval hypopigmented, slightly scaly patches on the upper body strongly suggested tinea versicolor, A, which was confirmed by a potassium hydroxide evaluation. The reason for the unilateral distribution of the eruption was not determined. The heat and sweating generated by the bodybuilding exercises may have predisposed the patient to this infection.

Pityriasis alba has indistinct borders and most frequently affects patients with atopy. Psoriasis and pityriasis rosea feature more scale and are more pruritic. Scale is absent in vitiligo, which is in the differential. ■