Abstract
Background: Pityriasis versicolor (PV), also known as tinea versicolor, is caused by Malassezia species. This condition is one of the most common superficial fungal infections worldwide, particularly in tropical climates. PV is difficult to cure and the chances for relapse or recurrent infections are high due to the presence of Malassezia in the normal skin flora. This review focuses on the clinical evidence supporting the efficacy of antifungal treatment for PV. Method: A systematic review of literature from the PubMed database was conducted up to 30 September 2014. The search criteria were “(pityriasis versicolor OR tinea versicolor) AND treatment”, with full text available and English language required. Conclusions: Topical antifungal medications are the first-line treatment for PV, including zinc pyrithione, ketoconazole, and terbinafine. In cases of severe or recalcitrant PV, the oral antifungal medications itraconazole and fluconazole may be more appropriate, with pramiconazole a possible future option. Oral terbinafine is not effective in treating PV and oral ketoconazole should no longer be prescribed. Maintenance, or prophylactic, therapy may be useful in preventing recurrent infection; however, at this time, there is limited research evaluating the efficacy of prophylactic antifungal treatment.
Highlights
Pityriasis versicolor (PV) is a chronic cutaneous fungal infection caused by proliferation of lipophilic yeast (Malassezia species) in the stratum corneum [1,2]
While evidence suggests that non-specific agents and older azoles can be effective in treating PV [7,8,9,10,11,12,13], the topical antifungals most extensively investigated recently are ketoconazole (Table 1) and terbinafine (Table 2)
As Malassezia species are endogenous to the skin flora, this condition is difficult to eradicate
Summary
Pityriasis versicolor (PV) is a chronic cutaneous fungal infection caused by proliferation of lipophilic yeast (Malassezia species) in the stratum corneum [1,2]. J. Fungi 2015, 1 cases of PV, Malassezia, as a part of normal skin flora, are not pathogenic unless they assume a mycelial form [2]. Fungi 2015, 1 cases of PV, Malassezia, as a part of normal skin flora, are not pathogenic unless they assume a mycelial form [2] This may be triggered by various factors, including humidity and high temperature, hyperhidrosis, familial susceptibility, and immunosuppression [1,2]. Patients with PV present with well demarcated round or oval macules on the trunk, neck, and upper arms where the density of sebaceous glands is high These lesions often appear hyperpigmented on lighter skin types and hypopigmented in darker or tanned skin and can vary in color [5].
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