10.5826/dpc.1202a57
text/xml
2160-9381
1812
en
Tejas Vishwanath
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Dermoscopy to the rescue in an annular enigma: a rare case of annular pityriasis versicolor presenting in an unusual location
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2022-05-02
2021-05-27
2022-05-02
2022-05-24
e2022057
Dermatol Pract Concept
Tejas Vishwanath
2022/05/02
10.5826/dpc.1202a57
e2022057
Dermatology Department, KEM Hospital, Mumbai, India
2160-9381
en
e2022057
Dermoscopy to the rescue in an annular enigma: a rare case of annular pityriasis versicolor presenting in an unusual location
https://dpcj.org/index.php/dpc/article/download/1812/1592
   Dermoscopy to the Rescue in an Annular Enigma:
     A Rare Case of Annular Pityriasis Versicolor
         Presenting in an Unusual Location
                              Farida Kapadia1, Vidya Kharkar1, Tejas Vishwanath1


1 Dermatology Department, KEM Hospital, Mumbai, India



Citation: Kapadia F, Kharkar V, Vishwanath T. Dermoscopy to the Rescue in an Annular Enigma: A Rare Case of Annular Pityriasis
Versicolor Presenting in an Unusual Location. Dermatol Pract Concept. 2022;12(2):e2022057. DOI: https://doi.org/10.5826/dpc.1202a57
Accepted: August 22, 2021; Published: April 2022
Copyright: ©2022 Rejeb et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication
Corresponding author: Dr. Tejas Vishwanath, MD Dermatology, Fellow at Kem Hospital, Mumbai, Acharya Dhonde Marg, Parel East,
Mumbai, India. E-mail: tejasvishwanath.igs@gmail.com




Case Presentation                                                       Teaching Point
    A 29-year-old female presented with asymptomatic an-                     Pityriasis versicolor presents with varied color tones and
nular plaques solely over the medial thighs since 1 month               morphologies.1,2 The annular variant noted in the present
(figure 1A, inset, 1B). Considering annular lichen planus and           case has not yet been described. Therefore, the diagnosis
porokeratosis, dermoscopy (polarized, Otiez dermoscope)                 was not clinically suspected. Dermoscopy was the game
was performed. It revealed attenuated central pigmentary                changer since it gave telltale clues: scales in skin creases
network and white scales and peripheral brown peripheral                along with pigment dilution. Peripheral brown scales with-
scales with accentuation in skin creases (Figure 1C). Scales            out accentuation in the creases constitute an unusual feature
disappeared after wiping with spirit swab (Figure 1D). On               probably due to retention parakeratosis since it disappeared
Woods lamp examination- yellowish fluorescence was seen                 on swabbing.
(Figure 1E). On potassium hydroxide mount with Chicago
Sky Blue, hyphae and spores were evident (Figure 1F). Thus,
a diagnosis of pityriasis versicolor was made.




Image Letter | Dermatol Pract Concept. 2022;12(2):e2022057                                                                           1
Figure 1. (A,B) Multiple discrete scaly annular patches with peripheral rim of hyperpigmentation and central hypopigmentation over bilat-
eral thighs. (C) Dermoscopy (captured with polarized dermoscopy, magnification x 10) revealed brown scales at the periphery of the lesion
with white fine scales at the center within the skin creases. (D) On wiping the lesion with an alcohol swab, dermoscopic analysis showed
complete disappearance of brown scales in the periphery with pigment dilution in the center. (E) Yellowish green fluorescence seen at Woods
lamp examination (F) KOH mount shows fungal spores and hyphae (spaghetti and meatball appearance).




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References                                                         2. Varada S, Dabade T, Loo DS. Uncommon presentations of
                                                                      tinea versicolor. Dermatol Pract Concept. 2014;4(3):93-96.
 1. Acharya R, Gyawalee M. Uncommon presentation of Pityri-           DOI: 10.5826/dpc.0403a21. PMID: 25126470. PMCID:
    asis versicolor; hyper and hypopigmentation in a same pa-         PMC4132011.
    tient with variable treatment response. Our Dermatol Online.
    2017;8(1):43-45. DOI:10.7241/ourd.20171.11




Image Letter | Dermatol Pract Concept. 2022;12(2):e2022057                                                                    3
