Varied Presentations of Tinea Versicolor: Case 4 Long-standing Tinea Versicolor

A 32-year-old African American man presented with an asymptomatic rash of 10 years’ duration. The patient reported that eruption abated during the winter. Tinea versicolor is often mistaken for vitiligo, which is more stable and does not produce scales. Heat and humidity can exacerbate this condition; thus, the rash typically resolves during the winter and worsens during the summer. This patient followed a daily regimen of applying ketoconazole( shampoo to his body, leaving it on for 10 minutes, then rinsing. Systemic antifungal agents are also effective; oral ketoconazole can be used in recalcitrant cases.

(Case and photograph courtesy of Dr Raymond Kuwahara.)