Background: Pityriasis versicolor is a common superficial fungal infection caused by Malassezia species. Diagnosis is often clinical, with confirmation through potassium hydroxide microscopy or Wood’s lamp examination. Dermoscopy has emerged as a non-invasive diagnostic tool, yet evidence from Sub-Saharan Africa remains limited.

Objective: To evaluate the diagnostic performance of dermoscopy compared with Wood’s lamp, using potassium hydroxide microscopy as the reference standard.

Methods: A hospital-based cross-sectional study was conducted among 113 adult patients with clinically diagnosed pityriasis versicolor at a tertiary dermatology clinic in South-East Nigeria. All participants underwent Wood’s lamp examination, dermoscopic assessment, and potassium hydroxide microscopy. Sensitivity, specificity, positive predictive value, negative predictive value, and receiver operating characteristic analysis were calculated.

Results: Potassium hydroxide microscopy confirmed pityriasis versicolor in 62 of 113 participants (54.9%). Dermoscopy demonstrated 100% sensitivity and 100% negative predictive value, with specificity of 7.8% and positive predictive value of 56.9%. Wood’s lamp showed sensitivity of 80.6%, specificity of 66.7%, positive predictive value of 74.6%, and negative predictive value of 66.7%. Receiver operating characteristic analysis revealed an area under the curve of 0.539 for dermoscopy and 0.737 for Wood’s lamp.

Conclusion: Dermoscopy identified all potassium hydroxide-positive cases in this cohort and may serve as a useful screening tool in low-resource settings. Wood’s lamp demonstrated higher specificity. Integrating dermoscopy with clinical assessment may enhance early diagnosis where microscopy is unavailable.

Pityriasis versicolor, dermoscopy, Wood’s lamp, potassium hydroxide microscopy, diagnostic accuracy, screening tools, resource limited settings, superficial fungal infections

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