Malassezia skin diseases in humans.

Although Malassezia yeasts are a part of the normal microflora, under certain conditions they can cause superficial skin infection, such as pityriasis versicolor (PV) and Malassezia folliculitis. Moreover the yeasts of the genus Malassezia have been associated with seborrheic dermatitis and dandruff, atopic dermatitis, psoriasis, and, less commonly, with confluent and reticulated papillomatosis, onychomycosis, and transient acantholytic dermatosis. The study of the clinical role of Malassezia species has been surrounded by controversy due to the relative difficulty in isolation, cultivation, and identification. This review focuses on the clinical, mycologic, and immunologic aspects of the various skin diseases associated with Malassezia. Moreover, since there exists little information about the epidemiology and ecology of Malassezia species in the Italian population and the clinical significance of these species is not fully distinguished, we will report data about a study we carried out. The aim of our study was the isolation and the identification of Malassezia species in PV-affected skin and non-affected skin in patients with PV and in clinically healthy individuals without any Malassezia associated skin disease.

Skin diseases associated with Malassezia species in humans. Clinical features and diagnostic criteria.

Malassezia yeasts not only cause the well known pityriasis versicolor and folliculitis, but also play an important role in other skin diseases, including seborrheic dermatitis and atopic dermatitis. The presence of Malassezia yeasts may be confirmed by direct microscopic examination and cultures of skin scrapings. In pityriasis versicolor the direct microscopic examination is the rapidest and surest test for confirming the clinical diagnosis. The preparation will show a cluster of globose budding spores with thick or double wall and short hyphae. For detecting Malassezia in the other diseases the cultures is preferable. Culture is useful both for confirming the clinical diagnosis and for epidemiological investigations. The identification of the Malassezia species is not easy. The microscopic observation of the colony direct towards the identification of Malassezia species, but it is not enough to identify the colonies definitely. Several biochemical tests are necessary for a precise identification, such as catalase reaction, growth on media without lipid sources, ability to utilize hydrophilic emulsifiers as sole lipid source, esculin test, tryptophan test.

Therapeutic experience with ketoconazole.

The efficacy of ketoconazole was evaluated in forty-five patients with dermatophytoses, in twelve with candidosis, in two with fixed cutaneous sporotrichosis, in one with primary cutaneous cryptococcosis and in one with pulmonary aspergillosis. Patients received 200 mg daily of ketoconazole until complete cure, except for patients with vulvovagnitis who received 400 mg daily for five days. All patients with dermatophytoses were cured within 20 to 40 days. No recurrences were observed at post-therapy follow-up. Patients with candidosis were also cured, with only one recurrence. Patients with deep mycoses recovered, except for one with fixed cutaneous sporotrichosis, who showed slight improvement. No significant side-effects were observed during therapy. In conclusion, ketoconazole is an effective therapeutic agent for fungal infections.

[Tungiasis: a rare consequence of the fascination by the exotic?]. / Tungiasi: rara conseguenza del fascino dell'esotico?

The paper reports three cases of tungiasis observed within the space of 6 months in patients who had spent part of their holidays in the Ivory Coast, Brazil and Senegal respectively. Spontaneous recovery probably makes the observation of this disease more rare.