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Hypopigmented Pruritic Facial Rashandndash;What is your Diagnosis? | OMICS International
ISSN: 2165-7920
Journal of Clinical Case Reports
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Hypopigmented Pruritic Facial Rash–What is your Diagnosis?

Subhankar Chakraborty*
Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
Corresponding Author : Subhankar Chakraborty
Department of Internal Medicine
University of Nebraska Medical Center
Omaha, NE- 68198-2055, USA
Tel: (978)-810-5992
E-mail: [email protected]
Received August 17, 2013; Accepted Septeber 16, 2013; Published September 18, 2013
Citation: Chakraborty S (2013) Hypopigmented Pruritic Facial Rash–What is your Diagnosis? J Clin Case Rep 3:301. doi:10.4172/2165-7920.1000301
Copyright: © 2013 Chakraborty S. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Dear Editor,
Hypopigmented skin lesions on the face are a common cause of cosmetic discomfort to patients. A 40 years old African American man comes to the clinic complaining of a discoloration of the skin (Figure 1). The rash was pruritic and caused him discomfort during social gatherings.
What is the diagnosis?
1. Vitiligo
2. Seborrheic dermatitis
3. Pityriasis rosea
4. Tinea versicolor
Answer:
Tinea versicolor
Discussion
Tinea versicolor (also called Pityriasis versicolor) is a superficial fungal infection caused by the dimorophic fungus Malassezia. “Versicolor” refers to the variation in skin pigmentation observed in this disorder. The lesions tend to occur in areas rich in sebaceous glands including the face and upper body. They can be hypo, hyperpigmentated or mildly erythematous. Characteristically patients notice it as the skin fails to tan on exposure to sunlight. Treatment is usually with topical antifungals (2% ketoconazole for 2 weeks, ketoconazole shampoo applied to affected area, selenium sulfide 2.5% lotion or shampoo for one week, terbinafine ointment twice daily for one week). Systemic treatment is reserved for widespread infection, recurrent infection or non response to topical antifungals. Fluconazole (300 mg once weekly for two weeks), Itraconazole (400 mg single dose) can be used. The patient had been on Ketoconazole ointment already for prior Tinea. Hence, he was prescribed Terbinafine topical ointment for 2 weeks.

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