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, observational studies and reviews published within the past 10 years.
Results:
Tinea versicolor is caused by Malassezia species, notably M. globosa, M. furfur and M. sympodialis. The condition is characterized by scaly hypopigmented or hyperpigmented macules/patches, primarily located on the upper trunk, neck and upper arms. The diagnosis is usually based on characteristic clinical features. If necessary, a
potassium hydroxide preparation test can be performed to reveal numerous short, stubby hyphae intermixed with clusters of spores. Most patients with
tinea versicolor respond to topical antifungal
therapy, which has a better safety profile (fewer adverse events, fewer drug interactions) and lower cost compared to systemic treatment and is therefore the treatment of choice. Oral antifungal
therapy is typically reserved for patients with extensive disease, frequent recurrences or disease that is refractory to topical
therapy. Advantages of oral antifungal
therapy include increased patient compliance, shorter
duration of treatment, increased convenience, less time involved with
therapy and reduced recurrence rates. On the other hand, oral antifungal
therapy is associated with higher cost, greater adverse events and potential
drug-drug interactions and is therefore not the first-line treatment for
tinea versicolor. Long-term intermittent prophylactic
therapy should be considered for patients with frequent recurrence of the disease.
Conclusion: Selection of
antifungal agents depends on several factors, including efficacy, safety, local availability, ease of administration, likelihood of compliance and potential drug interactions of the
antifungal agent.