Malassezia folliculitis

What is malassezia folliculitis?

Malassezia folliculitis, formerly known as pityrosporum folliculitis, is a infection of hair follicles caused by lipophilic Malasezia yeasts. There are multiple species of malassezia, including furfur, globosa, sympodialis, and restrictta [1]. Yeast is a normal inhabitant of human skin and only causes disease under specific conditions. [2].

Malassezia has been linked to a number of skin conditions, including seborrheic dermatitisfolliculitis confluent and lattice papillomatosis and pityriasis versicolor [3].

Who gets malassezia folliculitis?

Malassezia folliculitis is most commonly seen in adolescents and young adult males living in damp climates [3,4]. Other risk factors include:

• High tallow production [3,4]
• Hyperhidrosis (excessive sweating) [3,4]
• Occlusion since emollients and sunscreens

• Use of antibiotics [5]

• Oral steroids such as prednisone (steroid acne)

• Immunosuppression [6].

How does malassezia folliculitis present?

Malassezia folliculitis presents as a small, uniform itch. papules and pustules on the forehead, chin, neck, trunk and extensor muscle appearance of the upper extremities. They can sting.

How is malassezia folliculitis diagnosed?

The clinical examination is usually sufficient for the diagnosis. Laboratory investigations can be done.

• Preparation of potassium hydroxide from skin scrapings can reveal budding spores and hyphae. [7].
• Other stains, including the May-Grunwald-Giema stain, may also be helpful, but are used less frequently [1].
• Cultures are not done routinely, as malassezia species generally require special media for growth.

Malassezia folliculitis can also be suspected by finding organisms within the hair follicles in histopathological examination of a skin biopsy.

Malassezia folliculitis treatment

It is important to address any predisposing factors early on, as malassezia folliculitis has a tendency to recur.

Oral treatment is recommended as it has been shown to be much more effective than current agent. Fluconazole is used more often than itraconazole because of its higher side effect profile [8].

Topical agents (eg, selenium sulfide shampoo, econazole solution) can also be used, but should be reserved for those who cannot tolerate oral treatment [9,10].

Isotretinoin and photodynamic Therapy (PDT) has been used with some success in small case series [8,11,12].

Prevention of malassezia folliculitis

Reappearance it is common, even after successful treatment [10].

Long-term prophylaxis with topical agents can be considered in high-risk people or with multiple recurrences.

Periodic reassessment of predisposing factors is recommended.