Tinea Versicolor

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Basics

Description

  • Superficial fungal infection that interferes with normal skin pigmentation resulting in macules or patches that are hypopigmented, tan, brown, or salmon-colored. Tinea versicolor is usually well-demarcated, finely scaling, occurring primarily on the trunk and proximal upper extremities. Tinea versicolor is not a dermatophyte infection. It is caused by lipophilic (fat/oil-loving) Malassezia yeast organisms that normally inhabit the skin.
  • System(s) affected: skin/exocrine
  • Synonym(s): pityriasis versicolor

Epidemiology

Incidence
  • Common, occurs worldwide, especially in tropical climates
  • Predominant age: adolescents and young adults
  • Predominant sex: male = female

Pediatric Considerations
Skin eruptions usually occur after puberty, when sebaceous glands are more active. However tinea versicolor can also be seen in children, especially in tropical climates; facial lesions are more common in children.

Geriatric Considerations
Not common in the geriatric population

Prevalence
Prevalence can reach up to 50%, especially in warm climates.

Etiology and Pathophysiology

The inhibition of pigment synthesis in epidermal melanocytes leads to hypopigmented skin patches; in the hyperpigmented type, melanosomes increase in size resulting in brown or darker skin patches of varying shades (1).

  • Tinea versicolor is caused by 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 is associated with transformation of Malassezia from yeast cells to pathogenic mycelial form. Several endogenous (host) and exogenous/external factors may play a role in the transformation to active disease.
  • Tinea versicolor is not linked to poor hygiene.
  • Tinea versicolor is generally not contagious.

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

  • Prophylaxis can be used in warm summer months and prior to tanning season in people with frequent recurrences.
  • Avoiding skin oils may help
  • Tinea versicolor is not contagious.

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Basics

Description

  • Superficial fungal infection that interferes with normal skin pigmentation resulting in macules or patches that are hypopigmented, tan, brown, or salmon-colored. Tinea versicolor is usually well-demarcated, finely scaling, occurring primarily on the trunk and proximal upper extremities. Tinea versicolor is not a dermatophyte infection. It is caused by lipophilic (fat/oil-loving) Malassezia yeast organisms that normally inhabit the skin.
  • System(s) affected: skin/exocrine
  • Synonym(s): pityriasis versicolor

Epidemiology

Incidence
  • Common, occurs worldwide, especially in tropical climates
  • Predominant age: adolescents and young adults
  • Predominant sex: male = female

Pediatric Considerations
Skin eruptions usually occur after puberty, when sebaceous glands are more active. However tinea versicolor can also be seen in children, especially in tropical climates; facial lesions are more common in children.

Geriatric Considerations
Not common in the geriatric population

Prevalence
Prevalence can reach up to 50%, especially in warm climates.

Etiology and Pathophysiology

The inhibition of pigment synthesis in epidermal melanocytes leads to hypopigmented skin patches; in the hyperpigmented type, melanosomes increase in size resulting in brown or darker skin patches of varying shades (1).

  • Tinea versicolor is caused by 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 is associated with transformation of Malassezia from yeast cells to pathogenic mycelial form. Several endogenous (host) and exogenous/external factors may play a role in the transformation to active disease.
  • Tinea versicolor is not linked to poor hygiene.
  • Tinea versicolor is generally not contagious.

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

  • Prophylaxis can be used in warm summer months and prior to tanning season in people with frequent recurrences.
  • Avoiding skin oils may help
  • Tinea versicolor is not contagious.

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