What can a patient do to manage the rapidly spreading white patches on his back?

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As per the history and image provided (attachment removed to protect the patient's identity), the condition is Tinea versicolor. It is a fungal infection mostly appearing as white patches on the skin around the neck, shoulders, back, and sometimes face. The fungal elements are naturally present in every individual's skin as normal commensals, and the most common cause is the weakened immune system. When the fungal lesions flare up, they also appear in case of excessive sweating. They are not contagious and do not spread from one person to another but may appear in various areas within the body due to the overall lowering of immunity. Do not worry, as they can be reduced with the help of medications but may take time to fade. I suggest you take the following medications (consult a specialist doctor, discuss with them, and take medications with their consent). Ketoconazole soap for bathing twice daily. The soap must be applied after lathering during bathing only on the affected areas and kept for three minutes before washing off. A normal soap may be used for the rest of the unaffected areas of your skin. Bathing using Ketoconazole soap needs to be done twice daily for three months or till the rashes disappear. Daktarin gel (Miconazole gel) is to be applied twice daily on the patches in the morning and night after bathing with the soap and drying the affected area well. It is to be used for three months or till the patches disappear. Tablet Fluconazole 400 mg will be taken as a single dose and one more tablet after two weeks. A total of two tablets need to be taken with water after food at night. Capsule Becosule Z (multivitamins) to be taken after food daily for two months. This is to strengthen your immunity. Avoid sweating and stagnation of moisture. Always dry your body well after a bath. Wear loose clothes to avoid sweating. Consume more fruits and vegetables, and follow a balanced diet. Consume at least 12 glasses of water daily.