Which of the following is an appropriate treatment for pityriasis versicolor?

• A. 2.5% selenium sulfide shampoo
• B. Imidazole cream
• C. Oral fluconazole
• D. Topical hydrocortisone

Answer: (A)

Pityriasis versicolor is a superficial yeast infection of the skin caused by Malassezia. The treatment goal is to eradicate the yeast and resolve the scaling and pigment changes. A 2.5% selenium sulfide shampoo is a standard, effective topical option because selenium sulfide directly reduces the Malassezia load on the skin and helps shed the flaky scale, leading to clearance of the patches, especially on the trunk. It’s easy to apply over involved areas and rinse off after a short contact time, with repeated use as directed until resolution.

Imidazole creams are antifungals that can work, but a selenium sulfide shampoo is particularly reliable for broader surface areas of involvement. Oral fluconazole is a systemic option used for more extensive disease or when topical therapy fails, but it introduces systemic exposure and is not usually the first choice for mild to moderate cases. Topical hydrocortisone does not treat the fungal infection and can worsen fungal skin conditions by altering local immune responses.