Pityriasis Versicolor Differential Diagnosis Table

Pityriasis Versicolor Differential Diagnosis Table:

Also known as tinea versicolor, it is a fungal asymptomatic superficial condition. It is a chronic condition consisting of scaly patches well delimited, with different pigmentation patches that can be either hypo or hyperpigmented; also, it can be pink. They are distributed around the upper trunk, arms, abdomen, and armpits. Is very frequent in young adults.

How To Distinguish Pityriasis Versicolor From Other Diseases

Distinguish Epidermomycosis from Pityriasis Versicolor – Diagnosis

• Epidermomycosis is caused by dermatophytes, which are a family of fungi found in places with the presence of keratin: nails, hair, and skin, while pityriasis versicolor does not follow those characteristics.
• Epidermomycosis is a superficial infection and is characterized by annular or serpiginous plaques with pruritus, well-delimited, very active, and flaky edges with a clean center. Unlike pityriasis versicolor, consisting of scaly patches well delimited, with different pigmentation patches that can be either hypo or hyperpigmented; also, it can be pink.

Distinguish Vitiligo from Pityriasis Versicolor – Diagnosis

This condition affects 1% of the world’s population. It is a chronic disorder with a multifactorial predisposition and triggering factors that are characterized by big white macules all over the body.

• Vitiligo can start at any age but is more predominant between the ages from 10-30, while pityriasis versicolor is more frequent in young patients.
• Vitiligo has a strong genetic background since affected individuals usually have a family member with this condition, while pityriasis versicolor does not have a genetic background.
• Vitiligo is characterized by macules of more than 5 cm in chalk or white color, with well-defined edges, although there is also a tricolor vitiligo which consists of 3 colors: white, light brown, and dark brown, unlike pityriasis versicolor consisting of scaly patches well delimited, with different pigmentation patches that can be either hypo or hyperpigmented; also, it can be pink.

Distinguish Psoriasis from Pityriasis Versicolor – Diagnosis

Psoriasis occurs all over the world. It is a chronic disease with polygenic predisposition and environmental factors such as weather and stress.

• Psoriasis typical lesions are papules and chronic flaky plaques; pustules can also be present and erupt, unlike pityriasis versicolor consisting of scaly patches well delimited, with different pigmentation patches that can be either hypo or hyperpigmented; also, it can be pink.
• Patients with chronic inactive psoriasis lesions have well-delimited plaques of red color with white/silver laminated scales. If scales are removed, it will produce the ‘Auspitz sign’ where the plaques start bleeding out, while in pityriasis versicolor scales are not present.

Distinguish Eczema from Pityriasis Versicolor – Diagnosis

Eczemas are a group of conditions that produce inflammation and peeling of the skin.

• Eczemas are a group of autoimmune inflammatory diseases also known as dermatitis, meanwhile, pityriasis versicolor is a fungal infection.
• Eczemas are characterized by intense pruritus, dry and warm skin. In this condition, the skin is thick; you can also find papules and vesicles or scales according to the course of the condition, unlike pityriasis versicolor consisting of scaly patches well-delimited, with different pigmentation patches that can be either hypo or hyperpigmented; also, it can be pink.

Distinguish Seborrheic Dermatitis from Pityriasis Versicolor – Diagnosis

Seborrheic dermatitis is a chronic condition characterized by erythema and scales.

• Seborrheic dermatitis occurs in regions where there is major activity from sebaceous glands such as the face and scalp, while pityriasis versicolor is distributed around the upper trunk, arms, abdomen, and armpits.
• For seborrheic dermatitis, the age of onset is the lactation period, while pityriasis versicolor is more common in young adolescents.
• Seborrheic dermatitis lesions are orange skin, coarse macules with whitish flaking or plaques with well-defined edges, while pityriasis versicolor consists of scaly patches well-delimited, with different pigmentation patches that can be either hypo or hyperpigmented; also, it can be pink.

Distinguish Tinea Corporis from Pityriasis Versicolor – Diagnosis

Tinea corporis is a skin rash caused by a fungal infection.

• Tinea corporis lesions are pinkish ‘o’ shaped annular plaques and patches with gray raised edges and a clear center, while pityriasis versicolor consists of scaly patches well-delimited, with different pigmentation patches that can be either hypo or hyperpigmented; also, it can be pink.
• Tinea corporis can be transmitted through direct skin contact with infected people or by using personal elements of the infected person like a hairbrush, unlike pityriasis versicolor, which is not contagious.

Distinguish Annulare Granuloma from Pityriasis Versicolor – Diagnosis

Annulare Granuloma is a benign, idiopathic, chronic condition.

• Annulare granuloma consists of nodules and papules that form a ring with depressed skin inside; they can be red or skin-colored, while pityriasis versicolor consists of scaly patches well-delimited, with different pigmentation patches that can be either hypo or hyperpigmented; also, it can be pink.
• Annulare granuloma occurs most frequently on hands and foot, while pityriasis versicolor is distributed around the upper trunk, arms, abdomen, and armpits.

Distinguish Lichen Planus from Pityriasis Versicolor – Diagnosis

Lichen planus is a chronic inflammatory recurrent pruritic condition.

• Lichen planus lesions consist of solid lichenification plaques with a confluence of small papules, while pityriasis versicolor consists of scaly patches well-delimited, with different pigmentation patches that can be either hypo or hyperpigmented; also, it can be pink.
• Lichen planus skin seems and feels thick to touch during medical examination, while pityriasis versicolor skin is soft to touch.

Distinguish Erythrasma from Pityriasis Versicolor – Diagnosis

Erythrasma is a bacterial infection found in the skin folds of the skin.

• Erythrasma affects the stratum corneum of the skin and occurs in the interdigital, submammary, inguinal, and axillary folds, while pityriasis versicolor is distributed around the upper trunk, arms, abdomen, and armpits.
• Erythrasma consists of light brown plaques with fine scales, while pityriasis versicolor consists of scaly patches well-delimited, with different pigmentation patches that can be either hypo or hyperpigmented; also, it can be pink.
• Erythrasma is a bacterial infection, unlike pityriasis versicolor, which is a fungal condition.
• Erythrasma is very common in diabetic patients, while pityriasis versicolor is not identified with this epidemiological data.

Common Red Flags with Pityriasis Versicolor

Pityriasis versicolor affects individuals with a weak immune system and those who are malnourished, and it is not contagious. The lesions that produce this condition on the skin can remain after the fungus that produces them is eradicated.
Pityriasis versicolor has a good prognosis, and the treatment is decisive, although the patient may present another episode if the predisposing factors persist, such as high temperature, relative humidity, and excessive sweating.