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Brown spots on underarms, belly button. On ketoconazole, miconazole, zoloft. Pap smear test normal. History of high BP. Tinea versicolor?

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I have brown spots that started on both my underarms and have worked their way down beside my breasts and now I have spots around my belly button with a big cluster above my belly button. I have been given ketoconazole, miconazole, clotrimazole as well as an oral prescription to fight yeast. Originally the doctor had said it was tinea versicolor however none of the treatments are helping. This started about 13 months ago under my arms and about 8 months ago began to spread.I nave no spots below my waistline. I am 5'10 at 215 pounds, 26 years old, female, high blood pressure (both parents have high BP as well) and I am on zoloft 100mg a day for anxiety and depression (have been on it for about 5 years) and I am also on birth control. Never had menstrual issues or been irregular even without birth control. I do have excess facial hair on my chin that my general practicioner mentioned could be ovary related however she said it shouldn't be anything since I am not irregular and my pap smears come back normal.
Posted Sat, 14 Apr 2012 in Skin Hair and Nails
Answered by Dr. P V S Prasad 10 hours later

Thanks for posting your query.

I have gone through your pictures carefully and feel the most common possibility in your case could be Tinea versicolor- chronic type. It usually responds better to antifungals. Some times inspite of treatment the color may disappear only after six months.

Since you have this problem for more than 13 months, you may have undergo the following investigations by a doctor.

1. KOH smear examination from the patch.
2. Skin biopsy from the wedge of the lesion.
3. Fungal culture from the margin of the lesion.

It is not possible to make a diagnosis withour these. some times you still may have a fungal infection which could only respond to Itraconazole.

I hope, I have answered your query. I will be available for follow up queries if any.

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