Varied Presentations of Tinea Versicolor: Case 3 Papulosquamous Tinea Versicolor
A palpable papulosquamous, arciform chronic eruption
had been present in a 70-year-old man for many years.
The asymptomatic rash was in a “mantle” distribution—
across the upper shoulders, neck, and back.
A potassium hydroxide( (KOH) preparation demonstrated
the short, clustered hyphae and spores ofMalassezia furfur. The condition responded to topical econazole(.
It is uncommon for tinea versicolor to be palpably
and overtly scaly. However, given the eruption’s distribution,
the presence of spores as well as hyphae on the
KOH evaluation, the positive therapeutic response to appropriate
treatment, and the prevalence of this yeast infection,
the diagnosis of tinea versicolor was undoubtedly
correct.
The differential diagnosis included epidermal nevus
and tinea corporis. Epidermal nevus has a significant intradermal
component and is congenital, whereas tinea
versicolor is epidermal and acquired. Tinea corporis is
typically acute in onset and more inflammatory, but it can
be chronic.
(Case and photograph courtesy of Joe Monroe, PA-C.)