A study on histopathological and dermoscopic correlations in pityriasis versicolor

Abstract

Background: Pityriasis versicolor (PV) is a superficial mycoses caused by a lipophilic fungus; Malassezia yeast. Dermoscopy can be used as a complementary tool for assessing PV, but histopathology is confirmatory, whenever results of KOH (potassium hydroxide) examination are inconclusive. There is dearth of Indian data on the findings of dermoscopy and histopathology of PV. Objectives: To find the correlation between dermoscopic and histopathological features in Pityriasis versicolor. Materials and Methods: Fifty consecutive patients diagnosed with PV were recruited in the cross sectional study. KOH mount of the skin scrapings from the lesions was done on the patients and were positive in all the patients. Dermoscopy was done in all the patients using ILLUCO Dermoscope and features were noted. Biopsy was sent for histopathological examination. Results: Hypopigmented variant was the most common type (62%) in the patients. Dermoscopic analysis showed altered pigmentary network as the most common finding in almost all the patients, followed by scaling which was present in 21 patients. Folliculocentric pattern was seen in 20% of the patients. A peculiar finding contrast halo ring around the primary altered pigmentation was observed in 4 patients. Invasion of hair follicle by yeast was noticed in 18% patients. The most common histopathological change seen was perivascular infiltrate (78%) followed by hyperkeratosis (62%). There was presence of hyphae spores in 40% of the patients. 42% of the patients had spongiosis in their histopathological pattern. Special stain was done in 20 patients. Conclusion: Dermoscopy with features such as altered pigmentary network, contrast halo sign and yeast invasion of hair follicles when complemented with the histopathological features like perivascular infiltrate, hyperkeratosis, hyphae spores and spongiosis help in diagnosing PV.