Abstract
The local (cutaneous) hypothalamic–pituitary–adrenal (HPA) axis represents an important part of a self-regulating neuroendocrine system, which the skin developed to protect and maintain internal body homeostasis against environmental stressors. Disruption of the local HPA axis leads to an elevated pro-inflammatory and steroidogenic corticotropin-releasing hormone (CRH) that results in inflammation and lipids abnormality (quantitative and qualitative). Parallelly, the prolonged exposure of the skin to elevated cortisol weakens the protective epidermal barrier function, enabling pathogen colonization. Inflamed, oily, and compromised skin, frequently observed during TV infection, might be due to, among others, the local HPA axis dysregulation.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Further Reading
Ashbee HR, Glyn E, Evans V. Immunology of diseases associated with Malassezia species. Clin Microbiol Rev. 2002;15(1):21–57. https://doi.org/10.1128/CMR.15.1.21-57.2002.
Ashbee HR. Recent developments in the immunology and biology of Malassezia species. FEMS Immunol Med Microbiol. 2006;47(1):14–23. https://doi.org/10.1111/j.1574-695X.2006.00057.x.
Baz K, Kokturk A, Kaya TI, Ikizoglu G, Yazici AC, Bocekli E. Confetti-like pityriasis versicolor. JEADV. 2004;18:221–42.
Bhogal CS, Singal A, Baruah MC. Comparative efficacy of ketoconazole and fluconazole in the treatment of pityriasis versicolor: a one year follow-up study. J Dermatol Clin. 2001;28(10):535–9.
Bonifaz A, Gómez-Daza F, Paredes V, Ponce RM. Tinea versicolor, tinea nigra, white piedra, and black piedra. Clin Dermatol. 2010;28(2):140–5.
Brasch J, Mörig A, Neumann B, Proksch E. Expression of antimicrobial peptides and toll-like receptors is increased in tinea and pityriasis versicolor. Mycoses. 2014;57(3):147–52. https://doi.org/10.1111/myc.12118.
Chen Y, Lyga J. Brain-skin connection: stress, inflammation and skin aging. Inflamm Allergy Drug Targets. 2014;13(3):177–90. https://doi.org/10.2174/1871528113666140522104422.
Choe SJ, Kim D, Kim EJ, et al. Psychological stress deteriorates skin barrier function by activating 11β-hydroxysteroid dehydrogenase 1 and the HPA axis. Sci Rep. 2018;8(1):6334. https://doi.org/10.1038/s41598-018-24653-z.
Gupta AK, Cooper EA, Ginter G. Efficacy and safety of itraconazole use in children. Dermatol Clin. 2003;21:521–35.
Gupta D, Thappa DM. The enigma of color in tinea versicolor. Pigment Int. 2014;1:32–5.
Hay RJ. Malassezia, dandruff and seborrhoeic dermatitis: an overview. Br J Dermatol. 2011;165(Suppl 2):2–8.
Pantazidou A, Tebruegge M. Recurrent tinea versicolor: treatment with itraconazole or fluconazole? Arch Dis Child. 2007;92(11):1040–2.
Hudson A, Carroll B, Kim SJ. Folliculocentric tinea versicolor. Dermatol Online J. 2017;23(2):13030/qt5kj574bd.
Janjetovic Z, Jarrett SG, Lee EF, et al. Melatonin and its metabolites protect human melanocytes against UVB-induced damage: involvement of NRF2-mediated pathways. Sci Rep. 2017;7:1274. https://doi.org/10.1038/s41598-017-01305-2.
Juntachai W, Oura T, Murayama SY, Kajiwara S. The lipolytic enzymes activities of Malassezia species. Med Mycol. 2009;47(5):477–84. https://doi.org/10.1080/13693780802314825.
Kesavan S, Walters CE, Holland KT, Ingham E. The effects of Malassezia on pro-inflammatory cytokine production by human peripheral blood mononuclear cells in vitro. Med Mycol. 1998;36(2):97–106.
Minkel J, Moreta M, Muto J, et al. Sleep deprivation potentiates HPA axis stress reactivity in healthy adults. Health Psychol. 2014;33(11):1430–4. https://doi.org/10.1037/a0034219.
Nejati R, Skobowiat C, Slominski AT. Commentary on the practical guide for the study of sebaceous glands. Exp Dermatol. 2013;22(10):629–30. https://doi.org/10.1111/exd.12221.
Partap R, Kaur I, Chakrabarti A, Kumar B. Single-dose fluconazole versus itraconazole in pityriasis versicolor. Dermatology. 2004;208(1):55–9.
Pedrosa AF, Lisboa C, Gonçalves Rodrigues A. Malassezia infections: a medical conundrum. J Am Acad Dermatol. 2014;71(1):170–6. https://doi.org/10.1016/j.jaad.2013.12.022.
Romero-Sandoval K, Alves Costa A, Sousa AGT, Furucho CR, Valente N, Criado PR, Aoki V, Benard G. Recurrent and disseminated pityriasis versicolor: a novel clinical form consequent to Malassezia-host interaction? Med Hypotheses. 2017;109:139–44. https://doi.org/10.1016/j.mehy.2017.10.013.
Rotta I, Otuki MF, Sanches AC, Correr CJ. Efficacy of topical antifungal drugs in different dermatomycoses: a systematic review with meta-analysis. Rev Assoc Med Bras. 2012;58(3):308–18.
Rotta I, Ziegelmann PK, Otuki MF, Riveros BS, Bernardo NL, Correr CJ. Efficacy of topical antifungals in the treatment of dermatophytosis: a mixed-treatment comparison meta-analysis involving 14 treatments. JAMA Dermatol. 2013;149(3):341–9.
Santana JO, Azevedo FL, Campos Filho PC. Pityriasis versicolor: clinical-epidemiological characterization of patients in the urban area of Buerarema-BA. Brazil An Bras Dermatol. 2013;88(2):216–21. https://doi.org/10.1590/S0365-05962013000200005.
Schwartz RA. Superficial fungal infections. Lancet. 2004;364(9440):1173–82.
Silva H, Gibbs D, Arguedas J. A comparison of fluconazole with ketoconazole, itraconazole, and clotrimazole in the treatment of patients with pityriasis versicolor. Curr Ther Res. 1998;59(4):203–14.
Skobowiat C, Dowdy JC, Sayre RM, Tuckey RC, Slominski A. Cutaneous hypothalamic-pituitary-adrenal axis homolog: regulation by ultraviolet radiation. Am J Physiol Endocrinol Metab. 2011;301(3):E484–93. https://doi.org/10.1152/ajpendo.00217.2011.
Slominski A, Zbytek B, Nikolakis G, Manna PR, Skobowiat C, Zmijewski M, Li W, Janjetovic Z, Postlethwaite A, Zouboulis CC, Tuckey RC. Steroidogenesis in the skin: implications for local immune functions. J Steroid Biochem Mol Biol. 2013;137:107–23.
Slominski AT, Zmijewski MA, Plonka PM, Szaflarski JP, Paus R. How UV light touches the brain and endocrine system through skin, and why. Endocrinology. 2018;159(50):1992–2007. https://doi.org/10.1210/en.2017-03230.
Slominski AT, Zmijewski MA, Skobowiat C, Zbytek B, Slominski RM, Steketee JD. Sensing the environment: regulation of local and global homeostasis by the skin’s neuroendocrine system. Adv Anat Embryol Cell Biol. 2012;212:v–115. https://doi.org/10.1007/978-3-642-19683-6_1.
Vlachos C, Schulte BM, Magiatis P, Adema GJ, Gaitanis G. Malassezia-derived indoles activate the aryl hydrocarbon receptor and inhibit toll-like receptor-induced maturation in monocyte-derived dendritic cells. Br J Dermatol. 2012;167(3):496–505. https://doi.org/10.1111/j.1365-2133.2012.11014.x.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Zanardelli, M., Skobowiat, C., Kaliszuk, R., Pietrzak, A. (2023). Tinea Versicolor (Pityriasis Versicolor). In: Katsambas, A.D., Lotti, T.M., Dessinioti, C., D'Erme, A.M. (eds) European Handbook of Dermatological Treatments. Springer, Cham. https://doi.org/10.1007/978-3-031-15130-9_96
Download citation
DOI: https://doi.org/10.1007/978-3-031-15130-9_96
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-15129-3
Online ISBN: 978-3-031-15130-9
eBook Packages: MedicineMedicine (R0)