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Tinea Versicolor USMLE Notes & Mnemonics contains all the high-yield points you need to know.

  • Pityriasis Versicolor: A common fungal skin infection caused by the yeast Malassezia spp., characterized by hypo- or hyperpigmented, scaly patches.


  • More common in warm, humid environments. (Ref)
  • Frequently affects adolescents and young adults.


  • Overgrowth of the Malassezia yeast on the skin, disrupting normal pigmentation.

Clinical Features of Tinea Versicolor (Pityriasis Versicolor):

  • Patches on Skin: Often on the trunk and upper arms.
  • Hypo- or Hyperpigmented: Varies with skin tone and sun exposure.
  • Fine Scale: Noted on the surface of the lesions.
  • Asymptomatic: Rarely itchy or symptomatic.
  • Recurrence: Common, especially in warm, humid conditions.


  • Clinical Appearance: Characteristic look of lesions.
  • Wood’s Lamp Examination: Shows yellow-green fluorescence.
  • KOH (Potassium Hydroxide) Prep: “Spaghetti and meatballs” appearance under the microscope.


  • Topical Antifungals: Selenium sulfide, ketoconazole, or zinc pyrithione shampoos; terbinafine, clotrimazole, or miconazole creams.
  • Systemic Antifungals: Itraconazole or fluconazole for extensive or recurrent cases.


  • Avoiding excessive sweating, tight clothing.
  • Regular use of antifungal shampoos in endemic areas.

Mnemonic: “PITY Versicolor

  • Patches (hypo- or hyperpigmented)
  • Itchy (rarely)
  • Trunk and upper arms
  • Yeast (Malassezia)
  • Various colors
  • Environmental (warm, humid)
  • Recurrent
  • Scale (fine)
  • Identification (Wood’s lamp, KOH prep)
  • Control (antifungals)
  • Overgrowth of yeast
  • Lesions (distinct)

Chart: Pityriasis Versicolor Diagnosis and Treatment

Diagnostic ToolFindingTreatment Option
Clinical AppearanceHypo-/hyperpigmented patchesTopical Antifungals
Wood’s Lamp ExaminationYellow-green fluorescence
KOH Prep“Spaghetti and meatballs” appearanceSystemic Antifungals (for extensive cases)

Note: For the USMLE, focus on recognizing the clinical appearance of Pityriasis Versicolor, its association with Malassezia, and the treatment options. The condition is benign but can be a cosmetic concern for patients, and its recurrence is common. Understanding the “spaghetti and meatballs” appearance on KOH prep can be a key test point.

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