Exuberant clinical presentation of probable Malassezia folliculitis in a young nonimmunosuppressed patient.

Malassezia folliculitis is an inflammatory disorder observed in both immunocompetent and immunosuppressed patients. The authors describe an unusual and exuberant presumed case affecting the face, trunk and upper limbs of a 12-year-old nonimmunosuppressed patient. Although the agent was not identified by culture, the clinical and histopathological aspects plus the response to specific treatment support the diagnosis of Malassezia folliculitis. The only possible predisponent cause observed on the patient was greasy skin. Repetitive cultures were negative. Treatment with itraconazol promoted apparent cure, however, the patient relapsed twelve months later.

Exuberant clinical presentation of probable Malassezia folliculitis in a young nonimmunosuppressed patient / Apresentação clinica exuberante de provável foliculite por Malassezia em jovem imunocompetente

Malassezia folliculitis is an inflammatory disorder observed in both immunocompetent and immunosuppressed patients. The authors describe an unusual and exuberant presumed case affecting the face, trunk and upper limbs of a 12-year-old nonimmunosuppressed patient. Although the agent was not identified by culture, the clinical and histopathological aspects plus the response to specific treatment support the diagnosis of Malassezia folliculitis. The only possible predisponent cause observed on the patient was greasy skin. Repetitive cultures were negative. Treatment with itraconazol promoted apparent cure, however, the patient relapsed twelve months later.

Foliculite por Malassezia é processo inflamatório observado em pacientes imunocompetentes e imunossuprimidos. Os autores relatam um provável caso exuberante e incomum comprometendo a face, tronco e membros superiores de paciente de 12 anos de idade, não imunossuprimido. Embora o agente não tenha sido cultivado, os achados clínicos e histopatológicos aliados à resposta terapêutica sugerem o diagnóstico de foliculite por Malassezia. A única possivel causa predisponente demonstrada no paciente foi a pele oleosa. Tentativas de cultivo do agente foram negativas. O tratamento com itraconazol promoveu cura aparente, entretanto, houve recaída após 12 meses.

Case for diagnosis.

We report the case of a 58-year-old white female with Parkinson's disease. She evolved to an extensive livedo reticularis in the limbs and abdomen after commencing treatment with amantadine. We discuss the diagnostic approach to livedo reticularis and its differential diagnoses, emphasizing that the drug etiology must be considered when investigating livedo reticularis.

Case for diagnosis / Caso para diagnóstico

We report the case of a 58-year-old white female with Parkinson's disease. She evolved to an extensive livedo reticularis in the limbs and abdomen after commencing treatment with amantadine. We discuss the diagnostic approach to livedo reticularis and its differential diagnoses, emphasizing that the drug etiology must be considered when investigating livedo reticularis.

Descreve-se caso clínico de paciente feminina adulta, portadora de doença de Parkinson em uso de amantadina que desenvolveu extenso quadro de livedo reticular nos membros e abdome após o início do medicamento. Discutem-se a semiotécnica diagnóstica do livedo reticular e seus diferenciais. Os autores salientam que a etiologia medicamentosa deva ser considerada no diagnóstico dos livedos reticulares.