Last reviewed: 24 Aug 2023
Last updated: 04 Mar 2020
Summary
Definition
History and exam
Key diagnostic factors
- adolescent and young adult age
- history of living in area of high temperature and humidity
- susceptible skin characteristics
- positive drug history
- lack of pruritus or pain
- dyspigmentation
- macules or patches
- seborrheic distribution
- fine overlying scale
More key diagnostic factors
Other diagnostic factors
- yellow fluorescence under Wood lamp exam
Other diagnostic factors
Risk factors
- high ambient temperature and humidity
- adolescent and young adult age
- hyperhidrosis
- systemic corticosteroid or other immunosuppressant use
- participation in athletics
- greasy skin
- family history of PV
- malnutrition
- use of oral contraceptives
- HIV infection and other immunosuppressive conditions
- use of occlusive ointments or creams
More risk factors
Diagnostic investigations
1st investigations to order
- microscopic exam with KOH preparation
More 1st investigations to order
Investigations to consider
- skin biopsy
- culture
- Gram stain
More investigations to consider
Treatment algorithm
ACUTE
nonpregnant
pregnant
ONGOING
recurrent disease after successful pathogen eradication
Contributors
Authors
Brian L. Swick, MD

Clinical Professor
Departments of Dermatology and Pathology
University of Iowa
Iowa City
IA
Disclosures
BLS declares that he has no competing interests.
Peer reviewers
Hobart Walling, MD, PhD
Private Practice of Dermatology
Coralville
IA
Disclosures
HW declares that he has no competing interests.
Helen Goodyear, MBChB, MRCP, FRCPCH, MD, MMed
Consultant Paediatrician
Heartlands Hospital
Birmingham
UK
Disclosures
HG declares that she has no competing interests.
Differentials
- Vitiligo
- Tinea corporis
- Seborrheic dermatitis
More DifferentialsGuidelines
- Guidelines of care for superficial mycotic infections of the skin: Pityriasis (tinea) versicolor
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