Malassezia furfur folliculitis of the vulva: olive oil solves the mystery.
BACKGROUND
In treating women with chronic fungal infections, it is important to know which organism is responsible for the infection. In the past, organisms thought to cause vaginitis and vulvitis could all be cultured on modified Sabouraud agar.


METHODS
We describe a case of a woman whose chronic fungal vulvar folliculitis masqueraded as squamous epithelial hyperplasia. The 46-year-old woman, taking immunosuppressive therapy for rheumatoid arthritis, was referred with an 8-month history of vulvar vesicles, itching, and burning. Her examination revealed a vulvar folliculitis. When fungal cultures were initially negative, a vulvar biopsy revealed a squamous epithelial hyperplasia. However, a fungal culture covered with sterile olive oil eventually grew Malassezia furfur, a yeast with peculiar growth requirements. She was cured with a 2-week course of fluconazole.


CONCLUSIONS
Malassezia furfur, an organism rarely described in the vaginitis literature, can cause vulvar folliculitis in a patient on immunosuppressive therapy.
Nyirjesy
P
P
Department of Obstetrics, Gynecology, and Reproductive Sciences, Temple University School of Medicine, Philadelphia, Pennsylvania, USA.
Nixon
J M
JM
Jordan
C A
CA
Buckley
H R
HR
D003470:Culture Media; D005260:Female; D005499:Folliculitis / Q000382:microbiology*; D006801:Humans; D008290:Malassezia / Q000254:growth & development*; D008875:Middle Aged; D009181:Mycoses; D010938:Plant Oils; D014847:Vulvitis / Q000382:microbiology*
D003470:Culture Media; D010938:Plant Oils