What kind of disease is Malassezia folliculitis?

A skin condition caused by Malassezia infection of hair follicles, primarily manifested as papules and pustules.

Which department should be consulted for Malassezia folliculitis?

English name: Malassezia folliculitis.

Aliases: Pityrosporum folliculitis, Malassezia furfur folliculitis.

Department: Dermatology.

What are the causes of Malassezia folliculitis?

Malassezia is a group of lipophilic yeasts that are part of the normal skin flora. Several species of Malassezia can cause folliculitis, with Malassezia globosa, Malassezia sympodialis, Malassezia furfur, and Malassezia restricta being the most common.

Who is commonly affected by Malassezia folliculitis?

Adolescents and individuals living in hot, humid climates. People who sweat excessively may also be more prone to the condition. Long-term use of topical or oral antibiotics or a suppressed immune system can increase the risk of developing it.

What are the main symptoms and manifestations of Malassezia folliculitis?

Skin lesions primarily occur on the upper trunk, arms, and neck. They may sometimes appear on the face, though the central facial area is usually unaffected. The condition mainly presents as monomorphic papules and pustules around hair follicles, which may be itchy.

How is Malassezia folliculitis diagnosed?

Diagnosis relies on identifying high-risk populations, specific affected areas, and the presence of follicular papules or pustules. A Wood's lamp examination may show yellow-green fluorescence. A potassium hydroxide (KOH) smear revealing the yeast phase of Malassezia (fungal spores) can confirm the diagnosis.

How is Malassezia folliculitis treated?

Oral antifungal medications, such as fluconazole or itraconazole, are the first-line treatment. However, oral ketoconazole and terbinafine should be avoided—ketoconazole due to safety concerns and terbinafine due to ineffectiveness. Topical antifungals may help but are less effective than oral therapy.

Weekly use of selenium sulfide, ketoconazole, or ciclopirox as a preventive measure may be beneficial. Those with recurrent episodes after initial treatment may consider prophylaxis.

What is the prognosis for Malassezia folliculitis?

It has minimal impact on overall health but may cause itching and cosmetic concerns. Standard treatment yields relatively satisfactory results, though recurrence cannot be entirely prevented.