Hyperhidrosis and Environmental Factors in Recurrent Pityriasis Versicolor

Pityriasis versicolor (PV) is a chronic-recurrent superficial fungal infection caused by dermatophytes of the genus Malassezia. Despite effective antifungal treatments, its recurrence rate remains high. Hyperhidrosis and hot environmental conditions are major predisposing factors that create a microenvironment favorable for fungal growth. To report a case analyzing the role of hyperhidrosis and environmental factors in the recurrence of Pityriasis versicolor. A 35-year-old male presented with a long-standing history of recurrent scaly white patches on his neck and back since childhood, which worsened with age. The lesions multiplied over time, flared during sweating or heat exposure, and became more prominent after sun exposure. The patient and his family have a history of primary hyperhidrosis and similar skin lesions. His daily high-sweat activities and hot working environment significantly contributed to disease exacerbation. Dermatological examination revealed multiple hypopigmented macules with fine scales on the cervical and dorsal regions. Although symptoms temporarily resolved with antifungal therapy, frequent recurrences occurred due to persistent hyperhidrosis and environmental heat. Long-term management requires a combined strategy of antifungal treatment, control of hyperhidrosis, and lifestyle adjustments to reduce skin moisture. Hyperhidrosis and environmental heat play a critical role in driving the recurrence of Pityriasis versicolor. Effective management must address underlying predisposing factors alongside antifungal treatment to prevent relapse.