Tinea Versicolor

Tinea Versicolor is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Rash due to a common superficial mycosis with a variety of colors and changing shades of color, predominantly present on trunk and proximal upper extremities; macules are usually hypopigmented, light brown, or salmon-colored; fine scale is often apparent. It is not a dermatophyte infection.
  • System(s) affected: skin/exocrine
  • Synonym(s): pityriasis versicolor

Epidemiology

Incidence
  • Common, occurs worldwide, especially in tropical climates, where prevalence can reach 50%
  • Predominant age: teenagers and young adults
  • Predominant sex: male = female

Pediatric Considerations
Usually occurs after puberty (except in tropical areas); facial lesions are more common in children.

Geriatric Considerations
Not common in the geriatric population

Etiology and Pathophysiology

Inhibition of pigment synthesis in epidermal melanocytes, leading to hypomelanosis; in the hyperpigmented type, the melanosomes are large and heavily melanized (1).

  • Saprophytic yeast: Pityrosporum orbiculare (also known as Plasmodium ovale, Malassezia furfur, or Malassezia ovalis), which is a known colonizer of all humans
  • Development of clinical disease associated with transformation of Malassezia from yeast cells to pathogenic mycelial form likely multifactorial, due to host and/or external factors
  • Not linked to poor hygiene

Genetics
Genetic predisposition may exist.

Risk Factors

  • Hot, humid weather
  • Use of topical skin oils
  • Hyperhidrosis
  • HIV infection/immunosuppression
  • High cortisol levels (Cushing, prolonged steroid administration)
  • Pregnancy
  • Malnutrition
  • Oral contraceptives

General Prevention

  • Recheck and use prophylaxis each spring prior to tanning season.
  • Avoid skin oils.

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