Prevalence of Tinea Versicolor Higher in Underrepresented Groups

A new database analysis on the prevalence of tinea versicolor, otherwise known as pityriasis versicolor (PV), in underrepresented groups found that Black and Hispanic patients and individuals with physical disabilities were at an increased risk of the fungal infection.

This risk was exacerbated in some patients due to a lack of insurance, educational limitations, and financial stability.

Previous literature had suggested that PV disproportionately affects underrepresented groups compared to White patients. Despite this, the burden of PV has not been properly examined in these groups, which the investigative team led by Isabelle Moseley, MD candidate, Research Assistant at The Warren Alpert Medical School of Brown University in Rhode Island, suggested was due to frequent exclusion from studies evaluating the impact of skin conditions such as PV.

For the current study, Moseley and colleagues utilizedthe new National Institute of Health All of Us Research Program (AoU) to further define health disparities among underrepresented groups as they relate to PV and PV management.

The AoU defines underrepresented groups based not only on race/ethnicity, but by age (≥75 years), disability, sexual orientation/gender identity (LGBTQIA+), income (≤$35,000), and education (less than a high school degree).

Mosely and investigators estimated the prevalence of PV upon enrollment in each demographic group featured in the database by linking survey and electronic health data. Additionaly, the team evaluated the AoU Registered Tier dataset version 5, which included data collected between May 30, 2017 and April 1, 2021.

The dataset featured 329,038 participants, all of whom were 18 years or older. Among these participants, 251,597 had Electronic Health Record data and 1698 had PV. A multivariate logistic regression was used to estimate the adjusted odds ratio (OR) for PV diagnosis in each underrepresented group.

Compared to White patients, the team observed that Black (OR, 1.38; 95% CI, 1.21–1.59) and Hispanic (OR, 1.26; 95% CI, 1.09–1.44)patients had a higher adjusted odds of PV.

Meanwhile, LGBTQIA+ participants had a nonsignificant increased aOR (OR, 1.09; 95% CI, 0.93–1.05) , while physically disabled participants had a significantly increased aOR (OR, 1.26; 95% CI, 1.07–1.47).

Lower odds of PV were recorded in participants who were 75 years or older (OR, 0.49; 95% CI, 0.37–0.63), as well as in those with less than a high school degree (OR, 0.80; 95% CI, 0.65–0.97), household income of ≤$35,000 (OR, 0.78; 95% CI, 0.68–0.90), and no health insurance (OR, 0.42; 95% CI, 0.31–0.56).

The prevalence of PV recorded in AoU was consistent with the approximate 1% prevalence reported in various epidemiologic studies, which cited an increased risk of PV in Black and Hispanic patients and in those with physical disabilities.

“The AoU research program provides a useful platform for evaluating the burden of dermatologic diseases among underrepresented group,” the team wrote.