Vol3-2Art3

Pityriasis versicolor: current insights into pathogenesis, clinical variants, diagnosis, and management

Murat Durdu1,#, Macit Ilkit2

1Department of Dermatology, Adana Dr. Turgut Noyan Application and Research Center, Başkent University Faculty of Medicine, Adana, Türkiye; 2Division of Mycology, Department of Microbiology, Faculty of Medicine, Çukurova University, Adana, Türkiye

Abstract

Pityriasis versicolor, also known as tinea versicolor, is a common, benign, non-contagious superficial fungal disorder caused by lipophilic Malassezia species that colonize normal skin and can transform into a pathogenic hyphal form under favorable host and environmental conditions. It presents with hypopigmented, hyperpigmented, or erythematous, finely scaly macules and patches, most often on seborrheic areas. It occurs worldwide, with markedly higher prevalence in tropical and subtropical climates and peak incidence in adolescents and young adults. The species most frequently associated with the disease are M. globosa, M. furfur, and M. sympodialis, although distribution varies by region and mixed-species colonization can occur. Diagnosis is usually clinical; potassium hydroxide (KOH) preparation, Wood’s lamp examination, and dermoscopy are useful adjuncts, particularly in atypical cases and in the differential diagnosis of other pigmentary disorders. Topical antifungals remain the first-line treatment, oral therapy is reserved for extensive or refractory disease, and recurrence is frequent; residual dyspigmentation may persist for months after fungal clearance.

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#Correspondence:
sivandr@hotmail.com

Article info:
Received 15 August 2026
Revised 2 September 2026
Accepted 4 September 2026
Appeared online 9 September 2026
One Health Mycology 3(2): 140-151, 2026 doi.org/10.63049/OHM.26.32.3
This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/ licenses/by-nc-nd/4.0/)

Cite this article:
Durdu M, Ilkit M 2026. Pityriasis versicolor: current insights into pathogenesis, clinical variants, diagnosis, and management. One Health Mycology 3(2), 140-151

Keywords:
dermoscopy; Malassezia; potassium hydroxide; superficial mycoses; tinea versicolor; Wood’s lamp

Article highlights:

  • Pityriasis versicolor is a common superficial mycosis caused by the transformation of commensal Malassezia yeasts into a pathogenic hyphal form.
  • The genus Malassezia comprises 21 recognized species, with M. globosa, M. furfur, and M. sympodialis most frequently associated with pityriasis versicolor.
  • Clinical manifestations range from hypo- and hyper-pigmented to erythematous lesions, with atypical variants that may mimic other pigmentary and inflammatory dermatoses.
  • Potassium hydroxide (KOH) microscopy, Wood’s lamp examination, and dermoscopy provide complementary diagnostic information, particularly in atypical presentations.
  • Topical antifungals remain the mainstay of treatment, whereas systemic therapy and prophylactic strategies may be considered in extensive, refractory, or recurrent disease.