Axillary tinea versicolor caused by Malassezia furfur: Case report

Background: Tinea versicolor (TV) is common superficial fungal infection of the human skin characterized by scaling macula and mild disturbance of skin observed as pigmented and depigmented regions. Typically, it affects the chest, upper back, neck and shoulders. However, rarely, involvement of other unusual regions of the body such as the scalp and face, arms and legs, palms and soles, groin, vagina and axillary region has been reported. Case presentation: This case report is a case of axillary TV caused by Malassezia furfur that involved a 32-year-old woman that referred to Ghaem Medical Mycology Laboratory, Department of Health, Rescue and Treatment of Iran Police Force, in Tehran at February of 2018. Clinical appearance of lesions was erythematous or brownish pigmented macula with mild scaling of skin in involved areas. After sampling, to diagnosis, direct smears of 15% Potassium hydroxide (KOH) with scales and stained once with methylene blue were prepared. In direct microscopic examination, budding yeast cells with typical scar and short curved mycelium were observed. To identifying, culture on Sabouraud dextrose agar and modified Dixon agar media and other differential tests were performed. Finally, Malassezia furfur was identified as a causative agent of disease. The patient was taken on treatment of ketoconazole ointment for 4 weeks, approximately and lesions were disappeared. Conclusion: Malassezia furfur can causes Tinea versicolor in uncommon region such as axillary location. The clinicians must be aware of these variations in location of TV and perform the appropriate diagnostic workup when lesions have the characteristic morphology of TV despite an unusual location in order to differentiation from other disease such as candidiasis and erythrasma.