Questionnaire/history: Onset (eg insidious)? Multiple round or oval macules and confluent patches? Itch? - None? - Mild/moderate/severe? Past medical history? Current medication? Drug allergies? Examination: Multiple round or oval fawn, pink, red, brown or almost white macules and confluent patches? Fine scale? Distribution? - Upper trunk? - Upper arms? - Neck? - Abdomen? - Other? Images Management: Advised: - Not contagious as the yeast that causes it is normally present on human skin — infection is not due to poor hygiene - Treatment is usually highly effective, but may need to be repeated, as recurrence is common (especially in the summer months) - Following successful treatment skin discolouration may take several weeks or months to fully resolve - To read information 'Pityriasis versicolor' at www.bad.org.uk - For only small areas: clotrimazole, econazole or ketoconazole cream twice a day for up to 2–3 weeks OR - For extensive areas: ketoconazole 2% shampoo once daily for up to 5 days - to be lathered and left on affected skin for 3–5 minutes before thoroughly rinsing off - To seek medical advice if new or worsening symptoms, no improvement or ongoing symptoms after 12 weeks Reference(s): NICE CKS: Pityriasis versicolor Information for patient/carer(s): British Association of Dermatologists: Pityriasis versicolor