title: [Cutaneous Malassezia infections and Malassezia associated dermatoses: An update].
abstract: The lipophilic yeast fungus Malassezia (M.) spp. is the only fungal genus or species which is part of the physiological human microbiome. Today, at least 14 different Malassezia species are known; most of them can only be identified using molecular biological techniques. As a facultative pathogenic microorganism, Malassezia represents the causative agent both of superficial cutaneous infections and of blood stream infections. Pityriasis versicolor is the probably most frequent infection caused by Malassezia. Less common, Malassezia folliculitis occurs. There is only an episodic report on Malassezia-induced onychomycosis. Seborrhoeic dermatitis represents a Malassezia-associated inflammatory dermatosis. In addition, Malassezia allergenes should be considered as the trigger of "Head-Neck"-type atopic dermatitis. Ketoconazole possesses the strongest in vitro activity against Malassezia, and represents the treatment of choice for topical therapy of pityriasis versicolor. Alternatives include other azole antifungals but also the allylamine terbinafine and the hydroxypyridone antifungal agent ciclopirox olamine. "Antiseborrhoeic" agents, e.g. zinc pyrithione, selenium disulfide, and salicylic acid, are also effective in pityriasis versicolor. The drug of choice for oral treatment of pityriasis versicolor is itraconazole; an effective alternative represents fluconazole. Seborrhoeic dermatitis is best treated with topical medication, including topical corticosteroids and antifungal agents like ketoconazole or sertaconazole. Calcineurin inhibitors, e.g. pimecrolimus and tacrolimus, are reliable in seborrhoeic dermatitis, however are used off-label.
authors.affiliation: Labor für medizinische Mikrobiologie, Partnerschaft Prof. Dr. med. Pietro Nenoff & Dr. med. Constanze Krüger, Straße des Friedens 8, 04579, Mölbis, Deutschland, nenoff@mykologie-experten.de.
authors.forename: P
authors.initials: P
authors.lastname: Nenoff
authors.forename: C
authors.initials: C
authors.lastname: Krüger
authors.forename: P
authors.initials: P
authors.lastname: Mayser
mesh_terms: D000935:Antifungal Agents / Q000009:adverse effects / Q000627:therapeutic use; D003876:Dermatitis, Atopic / Q000175:diagnosis* / Q000188:drug therapy; D012628:Dermatitis, Seborrheic / Q000175:diagnosis* / Q000188:drug therapy; D017964:Itraconazole / Q000009:adverse effects / Q000627:therapeutic use; D007654:Ketoconazole / Q000009:adverse effects / Q000627:therapeutic use; D008290:Malassezia / Q000648:ultrastructure; D014010:Tinea Versicolor / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole; D007654:Ketoconazole