The role of Malassezia in atopic dermatitis affecting the head and neck of adults.
Atopic dermatitis is a common chronic skin condition. A subset of patients with head and neck dermatitis may have a reaction to Malassezia flora fueling their disease. Although there are no documented differences in Malassezia species colonization, patients with head and neck atopic dermatitis are more likely to have positive skin prick test results and Malassezia-specific IgE compared with healthy control subjects and patients with atopy without head and neck dermatitis. There is no clear relationship with atopy patch testing. The reaction to Malassezia is likely related to both humoral- and cell-mediated immunity. Clinically, Malassezia allergy may be suspected in patients with atopic dermatitis and: (1) head and neck lesions; (2) exacerbations during adolescence or young adulthood; (3) severe lesions recalcitrant to conventional therapy; and (4) other atopic diseases. There is literature to suggest that these patients will benefit from a 1- to 2-month course of daily itraconazole or ketoconazole followed by long-term weekly treatment.
Division of Dermatology, Ohio State University Medical Center, Columbus, Ohio, USA.
Kamruz
K
Darabi
Sarah Grim
SG
Hostetler
Mark A
MA
Bechtel
Matthew
M
Zirwas
D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D006257:Head; D006801:Humans; D008285:Major Histocompatibility Complex; D008290:Malassezia / Q000302:isolation & purification*; D009333:Neck