Malassezia yeasts and pityriasis versicolor

PURPOSE OF REVIEW

To analyze the relationships among different Malassezia species and pityriasis versicolor, the only human disease in which the etiologic role of these fungi is fully accepted (although the species implicated remains a matter of discussion).

RECENT FINDINGS

Since 1996, after the taxonomic revision of the genus, a limited number of papers analyzing the role of the different Malassezia species in pityriasis versicolor have been published or were the subject of presentations in congresses; there were only four in the past year. This paper discusses the results of these works, comparing them with results of the authors' most recent study in this field, conducted over the past 16 months.

SUMMARY

Most of the studies published thus far now show that Malassezia globosa is the predominant species found in the lesions of pityriasis versicolor, at least in temperate climates. The authors' recent findings confirm these results. The etiologic role of M. globosa in pityriasis versicolor is based, even more than on its isolation in a high percentage of cultures, on its identification by direct microscopy as typical globose yeast cells producing pseudohyphae in almost 100% of cases. The confirmation of the pathogenic role of this species in pityriasis versicolor could help in understanding these conditions, which are still unclear, which promote its transformation from the saprophytic stage present in healthy skin to the parasitic one, and could also help in selecting the best therapeutic measures.

[Tinea capitis in adults caused by Trichophyton violaceum. One case report]

Nowadays, tinea capitis is not the most frequent clinical presentation of dermatophytoses. Classically, Sabouraud defined this condition as common in childhood and rare in adults. Nevertheless, it is occasionally observed in adults, most frequently in women over 50 years-old. Trichophyton violaceum is one of the species isolated. We report this case for its rarity and to advise the clinician that one should consider a possible fungal infection in adults showing desquamating plaques in the scalp.

Malassezia species in skin diseases

Since the taxonomic revision carried out in 1996, enlarging the genus Malassezia to comprise seven different species, a number of studies have investigated from different points of view -- mycological, molecular and immunological -- the relationships of these species with the pathologies associated with lipophilic yeasts, as well as its presence in healthy skin. From these studies, it now appears clear that Malassezia globosa is the main species associated with pityriasis versicolor, which is the only cutaneous disease in which the involvement of Malassezia is undisputed. Nevertheless, this species can also be found in normal skin, in which the predominant species is Malassezia sympodialis. In the remaining dermatological disorders related to Malassezia, the role of these yeasts is controversial. In seborrhoeic dermatitis, atopic dermatitis and folliculitis, several studies have focused on the immunological aspects that could explain the pathogenic mechanism. In other diseases, such as confluent and reticulate papillomatosis, neonatal pustulosis, otitis and onychomycosis, the presence or significance of Malassezia is still a matter of dispute.