Prognosis

Spontaneous resolution of PV is uncommon, and the disease will persist for years if left untreated.[14] Fortunately, the treatment options for PV are safe and efficacious. However, even after successful treatment, patients and clinicians must remember that the pigmentary abnormalities associated with PV may take up to 6 weeks to resolve and that this is not a sign of treatment failure.[35] Hypopigmented lesions, in particular, can take longer to resolve.[20] In addition, because the conversion of Malassezia yeasts to the pathological mycelial form is thought to be due, in many cases, to endogenous host factors, recurrence is common in up to 60% of patients in the first year after treatment and up to 80% after 2 years.[7][36] Because of this, clinicians should consider prophylactic treatment for patients who tend to have repeated episodes of disease.[7]

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