Tinea versicolor (PV) is a skin disease. It is a superficial, benign fungal infection caused by a yeast called malassezia, forming part of the normal flora (saprophytic or commensal) of all human beings, since they are infants. It lives mainly in the pilosebaceous follicle.

This yeast is said to be lipophilic because its growth requires the presence of fatty acids found in sebum. PV is due to the transformation of this saprophytic yeast into a pathogenic filamentous form invading the superficial layers of the skin

The risks of getting tinea versicolor

PV is not a contagious skin disease (conjugal cases are very rare): it is a opportunistic infection, that is to say that it only develops in the event of favorable conditions.

Among these we can cite:

Intense and oily sweating

La seborrhea (fatty sweating), is correlated with the fact that the PV is seen especially between 18 in 40 years, period when seborrhea is the most important.

Thus, whatever causes the heavy sweating (sauna, hammam, intensive sports, wearing synthetic textiles …) can promote PV. Likewise, the PV grows more willingly during the summer in Europe and it is very common in the tropics.

Taking cortisone

Diffuse forms of PV are associated with a hypercorticisme  (Cushing’s syndrome, pregnancy, taking cortisone…).

Genetic ?

A genetic predisposition could explain the presence of cases in members of the same filiation not living together are affected.

Symptoms of Tinea versicolor

PV lesion is a rounded spot varying in color from buff-pink to “café-au-lait” brown, with clear boundaries, a few millimeters in diameter. It most often starts around a hair follicle (the “reservoir” area of malassezia) and it grows centrifugally.

The confluence of spots can range from a “drop” appearance to large webs with polycyclic contours.

After some weeks of evolution, or during exposure to the sun, the lesions become white and are particularly noticeable on tanned or black skin.

If you look at the lesions closely or scratch them gently, they are finely scaly (“Furfuraceous scales”).

The lesions are found mainly in the skin areas richest in sebaceous glands: upper back, thorax, shoulders, neck, arms, submammary region…

Only the palms and soles are never touched.

The injuries do not itch in the vast majority of cases

Examination in UV light with a Wood’s lamp reveals a pale greenish-yellow fluorescence, but fluorescence may be missing.

Treatments for tinea versicolor

L’cessation of contributing factors is important to limit the risk of recurrence (oily cosmetics, occlusive or synthetic clothing, etc.).

The doctor most often prescribes ketoconazole in single-dose foaming gel (Kétoconazole®, Kétoderm®…) to apply from hair to feet and leave to act for 5 minutes.

La high frequency of recurrence, reaching 60% the first year and 80% after 2 years is sometimes due to the persistence of contributing factors.

In the event of frequent recurrences despite the eradication of the contributing factors, some doctors prescribe a maintenance treatment with one or two applications per week for several months, others prefer a preventive treatment which consists of resume local treatment before or at the start of the summer season.

Le oral ketoconazole (Nizoral®) can prevent relapses at a dose of 400 mg once / month or at 200 mg / d for 3 consecutive days once a month. Likewise for theitraconazole (Sporanox®) at a dose of 400 mg once / month for 6 months.

Our doctor’s opinion