Tinea versicolor is a common fungal infection of the skin caused by certain species of Malassezia fungi, including Malassezia globosa, Malassezia furfur and Malassezia sympodialis. It presents with scaly patches of skin that can either have reduced or increased pigmentation. The affected areas are typically found on the upper trunk, neck and upper arms. Topical antifungal therapy is usually effective and is the preferred treatment option due to its safety profile, lower cost and fewer drug interactions compared to systemic treatment.

There are various formulations of topical antifungal medications available for treating tinea versicolor, such as shampoos, foams, gels, lotions and creams. These medications are typically applied once or twice daily, and treatment duration can range from a few days to 4 weeks. Higher concentrations of active ingredients and longer treatment durations have been associated with higher cure rates.

Topical azole drugs, including luliconazole, have emerged as an important class of treatment for tinea versicolor. These antifungal agents work by inhibiting the lanosterol 14-α-demethylase enzyme, which is involved in the synthesis of ergosterol—a vital component of fungal cell membranes. A decrease in the production of ergosterol can hinder cell growth and function. The most common side effects of topical antifungal agents are skin irritation and contact allergy. Randomized clinical trials have provided evidence to support the efficacy of various topical azole antifungal agents in treating tinea versicolor.

Source: Leung AK, Barankin B, Lam JM, Leong KF, Hon KL. Tinea versicolor: an updated review. Drugs Context. 2022;11:2022-9-2.