A 24-year-old male presents to the clinic with a history of hypopigmented patches over his chest since 6 months. Mild itching is present. The skin scraping was taken and KOH mount was prepared. On microscopy, the appearance as shown below is observed. What is the most probable diagnosis?

Correct Answer: Pityriasis versicolor
Description: The given clinical picture and the KOH mount preparation showing the spaghetti and meatball appearance is suggestive of Pityriasis Versicolor. Pityriasis Versicolor is a chronic superficial infection of the stratum corneum caused by Malassezia globosa and Malassezia furfur. The most common site involves the neck, chest, back, and upper arms. The lesions often appear as hypopigmented areas. The KOH mount reveals fungal hyphae that are sho and thick (like spaghetti or banana) and a large number of variously sized spores (like meatballs or grapes) referred to as Spaghetti & meatballs or Bananas & grapes appearance. Treatment includes topical azoles or terbinafine for 2 weeks Reference: Paniker&;s Textbook of Medical Parasitology 8th edition
Category: Microbiology
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