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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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Citation

Stephens, Mark B., et al., editors. "Tinea Versicolor." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116606/all/Tinea_Versicolor.
Tinea Versicolor. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116606/all/Tinea_Versicolor. Accessed April 18, 2019.
Tinea Versicolor. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116606/all/Tinea_Versicolor
Tinea Versicolor [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 18]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116606/all/Tinea_Versicolor.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Tinea Versicolor ID - 116606 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116606/all/Tinea_Versicolor PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -