Age-Related Clinical Patterns and Presentations of Tinea Versicolor: A Cross-Sectional Study

Abstract

BACKGROUND: Tinea versicolor (TV) is a common superficial fungal infection caused by Malassezia species. While generally considered a condition of young adults, TV can affect individuals across a wide age spectrum. However, age-specific clinical presentations and patterns have not been well characterized in the literature. Understanding how TV presents across different age groups could inform clinical diagnosis and management strategies. OBJECTIVE: This study aimed to characterize the clinical presentations of TV across different age groups and identify age-related patterns in lesion type, distribution, and associated factors. METHODS: A hospital-based cross-sectional study was conducted at the dermatology outpatient clinic of Al Karamah Teaching Hospital, from June 2019 to February 2020. Consecutive patients diagnosed with TV were enrolled. Data on age, clinical characteristics (lesion type, anatomical distribution, skin type), and comorbidities were collected. Patients were categorized into three age groups: 30 years (older adult). Chi-square test and Pearson correlation were used for statistical analysis. RESULTS: A total of 70 patients with TV were enrolled, with ages ranging from eight to 62 years (mean: 27.6 ± 11.4 years). The distribution across age groups was: 30 years (28.6%, n=20). Hyperpigmented lesions were more common in younger patients (30 years: 35.0%, p=0.03). Conversely, hypopigmented lesions increased with age (30 years: 60.0%, p=0.02). Pediatric/adolescent patients (30 years: 60.0%, p=0.02). Pediatric/adolescent patients (30 years, p=0.04). Comorbidities, particularly diabetes mellitus, were significantly more common in older patients (85.0% in >30 years vs. 5.0% in <20 years, p<0.001), while younger patients showed higher rates of concurrent acne vulgaris (70.0% vs. 10.0%, p<0.001). CONCLUSIONS: TV demonstrates distinct age-related clinical patterns, with younger patients more likely to present with hyperpigmented lesions, facial involvement, and seborrheic skin, while older patients show predominantly hypopigmented lesions and a higher comorbidity burden. These findings suggest that age-specific diagnostic and management approaches may be beneficial. The identification of TV in pediatric patients should prompt evaluation for acne, while TV in older adults warrants screening for metabolic conditions. This study contributes important data on pediatric TV presentation, an understudied area in dermatology literature.