When should I consider referring a patient with pityriasis versicolor to a dermatologist?

Consider referring a patient with pityriasis versicolor to a dermatologist if:

• The diagnosis is uncertain or skin scraping microscopy is negative, as specialist assessment including Wood's light examination may aid diagnosis.
• There is an inadequate response to optimal treatment in primary care.
• The pityriasis versicolor is severe or very extensive.
• The patient is a child or pregnant woman, where management options are limited in primary care.
• The patient is immunocompromised, depending on clinical judgement.
• Long-term oral antifungal prophylaxis may be needed for recurrent or severe episodes.

These referral considerations are based on pragmatic clinical practice to ensure appropriate specialist input when diagnosis or management is challenging.