Tinea versicolor: an updated review

Abstract

A search was conducted in July 2022 in PubMed Clinical Queries using the key terms "tinea versicolor" OR "pityriasis versicolor". The search strategy included all clinical trials (including open trials, non-randomized controlled trials and randomized controlled trials), observational studies and reviews (including narrative reviews and meta-analyses) published within the past 10 years. Only papers published in the English literature were included in this review. The information retrieved from the search was used in the compilation of this article. Review AetiopathogenesisTinea versicolor is caused by dimorphic lipophilic and lipid-dependent yeasts in the genus Malassezia (formerly known as Pityrosporum) species, notably Malassezia globosa (M. globose), M. furfur and M. sympodialis. [2][3][4][5][6][7][8][9][10][11][12] Other species that have been implicated include M. restricta, M. obtuse, M. slooffiae, M. pachydermatis and M. japonica. [13][14][15][16] These yeasts are normal commensals on the skin surface. 17,18 Skin colonization increases with age; 25% of children and almost 100% of adults are affected. 19 Tinea versicolor occurs when the saprophytic yeast or budding form of the organism converts to the pathogenic hyphal or mycelial form. The fungal infection is localized to the stratum corneum. Predisposing factors for the conversion include a hot and humid environment, hyperhidrosis, application of oily lotion or cream to the skin, wearing of masks, excessive lipid-containing sebaceous secretions, malnutrition, poor general health, use of oral contraceptives, pregnancy, diabetes mellitus, use of topical or systemic corticosteroids, Cushing disease, Helicobacter pylori infection, immunodeficiency and genetic predisposition. [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] A recent study showed oxidative stress has no role in the pathogenesis of tinea versicolor. 29

Dermoscopic Assessment of Pityriasis Versicolor: A Cross-Sectional Observational Study

“…Examination of the lesion with a Wood's lamp may show gold-yellow, yellowish-green, or coppery-orange fluorescence, although some lesions do not fluoresce. 11 Other investigations, such as culture and molecular methods, are time-consuming and expensive. 5 Dermoscopy, or skin surface microscopy, is a noninvasive tool that was previously used in the evaluation of skin malignancies and has emerged as an important aid in the diagnosis of other nonmalignant skin conditions during the last decade.…”

“…Examination of the lesion with a Wood’s lamp may show gold-yellow, yellowish-green, or coppery-orange fluorescence, although some lesions do not fluoresce. 11 Other investigations, such as culture and molecular methods, are time-consuming and expensive. 5…”

“…The evoked scale sign was elicited, in which the lesion was stretched between the forefinger and thumb thereby making the fine scales over the lesion more apparent. [10][11] One representative lesion from each patient was selected and subjected to dermoscopy using a handheld pocket dermoscope (DermLite DL4; DermLite LLC, San Juan Capistrano, California, USA). The glass plate of the instrument was placed directly over the skin lesion, and the lesions were observed in polarized mode at 10× magnification without any contact medium.…”