Question
A 26 year old male had multiple small hypopigmented macules on the upper chest & back for the last 3 months . The macules were circular , arranged around follicles & many had coalesced to form large sheets . The surface showed fine scaling . He had similar lesions one year ago which subsided with treatment . The most appropriate investigation to confirm the diagnosis is :
| A. |
Slit skin smear
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| B. |
Tzanck smear
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| C. |
Potassium hydroxide mount
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| D. |
Skin biopsy
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Show Answer
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Correct Answer � C
Explanation
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Correct answer : c
Diagnosis here is Pityriasis versicolor : CLUES are chest and trunk having hypopigmented macules with fine scaling around follicles which coalesced to form large sheets , with history of similar complaints in past .
Aetiology : Malassezia globosa (MOST COMMON).M.furfur , M.sympodialis.
Since itÕs a lipophilic fungus it colonizes seborrheic and perifollicular areas.
Clinical features : Asymptomatic Hypopigmented (due to Azelaic acid) , sometimes Hyperpigmented (due to abnormally large melanosomes)
SCRATCH SIGN positive.
IT IS NOT A DERMATOPHYTE INFECTION.
Investigation : Woods lamp examination ˆ Yellow fluorescence .
Potassium hydroxide (KOH) mount Spaghetti & Meat ball appearance.
Treatment : Topical Azoles are drug of choice (DOC)
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