title: Granulomatous dermatitis due to Malassezia sympodialis.
abstract: A 67-year-old man, with multiple skin lesions that appeared over 2 years, had biopsies that disclosed granulomatous dermatitis with associated small yeasts. The urinary antigen test results were negative for Histoplasma infection; cultures from the biopsies did not grow any fungi or other potential pathogens. The chest roentgenogram results were normal. Morphologic examination revealed features of a Malassezia species. Broad-range fungal polymerase chain reaction and DNA sequencing disclosed that the infecting fungus was Malassezia sympodialis , a lipid-dependent yeast. This report supports one other case report that Malassezia species may cause granulomatous dermatitis; in the previous case, the etiologic agent was Malassezia pachydermatis , a nonlipid-dependent species. We recommend the use of lipid-supplemented culture media for specimens from patients with granulomatous dermatitis because several Malassezia species are dependent on lipid; the absence of lipid supplementation in routine cultures likely explains the negative culture results for this patient. This, to our knowledge, is the first report of granulomatous dermatitis caused by M sympodialis.
authors: Department of Pathology and Laboratory Medicine, Cleveland Clinic, Cleveland, OH 44195, USA.
authors: Harsha B
authors: HB
authors: Desai
authors: Philip L
authors: PL
authors: Perkins
authors: Gary W
authors: GW
authors: Procop
mesh_terms: D000368:Aged; D001706:Biopsy; D003872:Dermatitis / Q000175:diagnosis* / Q000382:microbiology* / Q000473:pathology; D003881:Dermatomycoses / Q000150:complications* / Q000382:microbiology; D006099:Granuloma / Q000175:diagnosis* / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D008290:Malassezia / Q000302:isolation & purification; D008297:Male; D012867:Skin / Q000382:microbiology / Q000473:pathology