Chronic yeast overgrowth on the skin, not contagious, producing white, brown, or pink scaling oval patches on the trunk is:

• A. Tinea versicolor
• B. Pityriasis alba
• C. Vitiligo
• D. Intertrigo

Answer: (D)

Chronic Malassezia yeast overgrowth on the skin producing white, brown, or pink scaling oval patches on the trunk is most consistent with tinea versicolor. This is a superficial fungal infection of the stratum corneum caused by Malassezia species. The pigment changes occur because the yeast disrupts melanocytes, leading to hypo- or hyperpigmented, finely scaled patches that often appear on the chest and back and may be more noticeable after sun exposure. It is not highly contagious, since the yeast is part of normal skin flora and overgrowth is due to factors like heat and humidity.

Diagnostic clues include a characteristic fine scale on inspection and, if tested, a KOH preparation showing yeast with short hyphae (the spaghetti-and-meatballs appearance). Wood’s lamp may show a copper-orange fluorescence, supporting the diagnosis. Treatment targets the yeast and the skin surface, with options like selenium sulfide or zinc pyrithione shampoos, and topical azoles such as ketoconazole; in extensive cases, oral antifungals like fluconazole or itraconazole may be used.

Pityriasis alba presents as pale, fine-scaling patches usually on the faces of children; vitiligo shows depigmented patches without scale; intertrigo involves inflammation and irritation in skin folds, not isolated oval trunk patches with scaling from yeast.