Jide's family was convinced the pale patches spreading across his chest were vitiligo. Mascot Healthcare identified pityriasis versicolor — a common, completely curable fungal condition — with a simple skin test.
Swimmer, Apapa. Presented with multiple pale, slightly scaly patches on the chest, back, and upper arms — present for 4 months. Patches failed to tan during sun exposure and became more visible after swimming. Presumed vitiligo by self and family.
Pityriasis VersicolorJide had noticed the first pale patch while changing after swimming in February. By March there were six or seven. His mother looked at them and said: "That looks like vitiligo — my cousin had that, it spread to her whole face."
The family was alarmed. His uncle recommended a traditional skin remedy. His girlfriend suggested shea butter. By the time he came to Mascot Healthcare, four months had passed and the family was convinced he was developing vitiligo.
The doctor examined the patches with a Wood's lamp (UV light) — classic yellow-orange fluorescence, diagnostic of Malassezia furfur, the causative fungus. A skin scraping KOH preparation was performed — spaghetti-and-meatball appearance (short hyphae and spores) confirmed pityriasis versicolor.
Pityriasis versicolor is a superficial fungal infection that disrupts skin melanin production, causing hypopigmented (pale) or occasionally hyperpigmented patches. It is very commonly misidentified as vitiligo — which has a very different prognosis.
Scattered, slightly scaly, pale patches on the chest, back, and upper arms — appearing over 4 months.
The affected skin did not darken in the sun with the rest of his body — a characteristic feature.
A subtle fine scale on the surface of each patch — visible on close inspection or with a torch from the side.
Patches became more obvious after swimming, when surrounding skin was flushed and the patches were not.
Almost entirely asymptomatic — noticed only because of the colour contrast.
Traditional skin lightening preparations — no antifungal effect; potentially irritating.
Shea butter — moisturising; no antifungal effect.
Sun exposure to "even out" the skin — patches do not tan; sun made the contrast more visible.
Diagnosis confirmed on Wood's lamp and KOH preparation. Treatment: a medicated shampoo used as a body wash — applied to the chest, back, and arms, left for 5 minutes before rinsing, daily for a few weeks. The shampoo delivers the treatment across the entire affected surface area efficiently.
Jide was counselled: the fungus clears with treatment, but pigmentation takes 1–3 months to return fully — the patches will fade gradually even after the fungus is gone, as melanin production recovers.
He was also warned about recurrence (Malassezia is a normal skin organism that can overgrow again, especially in hot and humid conditions) and given guidance on maintenance with monthly medicated shampoo washes during the hot season.
Pityriasis Versicolor — Malassezia furfur (Wood's lamp: positive yellow-orange fluorescence; KOH: spaghetti-and-meatball pattern)
Medicated shampoo body wash for a few weeks; maintenance: monthly wash in hot season; counselled on pigmentation recovery timeline
At 3 weeks: scale completely gone. At 2 months: patches fading as pigmentation recovers. At 3 months: patches nearly fully repigmented.
All patches faded and repigmented within 3 months. The family's fear of vitiligo resolved. Jide uses a monthly medicated shampoo for maintenance during the hot season.
Pityriasis versicolor is very commonly mistaken for vitiligo in Nigeria. The key difference: PV patches have a fine scale and respond quickly to antifungal treatment; vitiligo is purely pigmentation with no scale and does not respond to antifungals.
Wood's lamp examination distinguishes the two conditions immediately. A three-week shampoo course cures PV completely.
Pale skin patches with a fine scale are not vitiligo — they may be a fungal infection that clears in 3 weeks.
Book an appointment at Mascot Healthcare, Akoka — same-day slots often available, 4.9★ rated.