The confluence of small, scaly, hyperpigmented patches on the chest (and often neck and upper back) is classic for tinea versicolor.
A 24-year-old man was concerned about a very mildly pruritic rash on the chest. The rest of the cutaneous examination was normal. The family and past medical histories were non-contributory.
Key point: The confluence of small, scaly, hyperpigmented patches on the chest (and often neck and upper back) is classic for tinea versicolor. This common superficial fungal infection tends to recur each warm season during young adult life.
Treatment: The fungus that causes this is best eliminated by ketoconazole. This agent can be administered orally or topically, using any number of different regimens.
Note: To prevent recurrence, have the patient use a 5% benzoyl peroxide wash 1 or 2 times a week when spring begins.