Pityriasis Versicolor of Scalp Mimicking Alopecia Areata

A 9-year-old boy experienced progressive, nonitchy, patchy scalp alopecia over 3 months, initially suspected to be alopecia areata. However, examination revealed erythematous patches with sparse hair stumps and fine scaling, and potassium hydroxide microscopy confirmed tinea versicolor caused by Malassezia, which is rare on the scalp. Treatment with topical ketoconazole and selenium sulfide resulted in full hair regrowth within 6 weeks. The case highlights that rising heat and humidity may lead to atypical presentations of scalp conditions in children.