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Malassezia Infections
Alternate

Names:
Pityrosporum
Obsolete

(Images courtesy of http://www.buyaldaracream.com/buydiflucan.htm and http://208.88.129.137/product/catalog/

product_detail.aspx?
id=36&prodid=154&seachproducts=K)

name for

this genus
Yeast

Infections

Malassezia Infections
Presentation Developed By: Courtney Madden, Megan
Lileas & Nita Gupta

Malassezia Taxonomy

Malassezia Infections

Kingdom: Fungi

Etiologic Agent and Taxonomy

(11 species):

Phylum: Basidiomycota

Class: Hymenomycetes

Order: Tremellales

Family: Filobasidiaceae

Genus: Malassezia

Malassezia

A colononizing yeast found

on dermis and other body
surfaces of humans and
animals
Most species require long
fatty-acid chains to grow
well (lipophilic)-except M.
pachydermatis
Normal skin flora- colonies
found on up to 90% of adults
(www.doctorfungus.com)
Cells are globular to
ellipsoidal in shape
Conidia (asexual spore off
hyphae branch) is primary
form

Malassezia furfur-most
common
Malassezia globosa
Malassezia obtusa-rarely
recovered
Malassezia restricta
Malassezia sloofiae
Malassezia sympodialis
Malassezia pachydermatis
Malassezia dermatis
Malassezia japonica
Malassezia nana
Malassezia yamatoensis

Malassezia Geographical Distribution

(Image courtesy of www.dsc.dicovery.com)

More common in adults

More common in tropical
areas with up to a 40-60%
infection rate (Clinical
Mycology)
Japan- M. sympodialis, M.
furfur
Spain- M. sympodialis, M.
globosa
M. globosa- commonly seen
in the scalps of UK residents
M. furfur- tropical areas

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Malassezia Life Cycle

Malassezia Life Cycle

No telomere phase
Yeast cells and hyphae
Found as colony on skin in
budding forms
Raised and smooth in
cultures
Get dry and wrinkled as
they age
During an infection change
to mycelial form
In temperate regions
clusters of hyphae suggesting
form differs depending of
location

(Image courtesy of http://www.mycology.adelaide.edu.au/

Mycoses/Superficial/Malassezia_infections/)

Epidemiology

Patients who are affected

by immuno-suppressant
conditions such as AIDS
are at a higher risk of
contracting an infection
Adults carry more
Malassezia than children
An increase in Malassezia
is found on teenagers
because the increased
activity in sebaceous
glands provides nutrition
for the lipophilic yeast

Epidemiology

(images courtesy of http://dailynewsstore.blogspot.com/

2009/11/aids-pictures.html & http://www.medindia.net/
beauty/facepimples.asp)

Occurs in healthy and

immune compromised
people
Very common fungal
disease that stays a very
long time on skin
M. globosa & M. sympodialis
Budding yeasts
Occurs in hot, humid
climates

(Images courtesy of http://www.kaboodle.com & http://

getpregnant2day.com/getting-pregnant/)

Pathogenesis: Pityriasis versicolor

Asexually reproduction
only
Collarettes
Usually single buds
Mature in about 5 days
in 30-37 degree climate
Vary in color from
creamy yellow to brown
or orange-beige

Skin rash on the trunk that

is usually discolored, slightly
reddish brown
Treatment with dandruff
medications or anti-fungals
(Image courtesy of http://www.patient.co.uk/doctor/
Pityriasis-Versicolor.htm)

People receiving antibiotics

or steroid treatment are
more susceptible
Higher risk in pregnant
women and diabetics
Common in tropics
Relapses may occur with
anti-dandruff or anti-fungal
drugs
Neonatals who are on
parenteral nourishment with
lipids

Pathogenesis: Pityriasis Versicolor

Occurs in healthy and immuno-compromised patients

Also known as Tinea Versicolor
Caused by the excessive growth of Pityrosporum orbiculare
(Malassezia furfur). Also caused by M. globosa and M.
sympodialis
Profuse perspiration and an abundance of oil produced in
skin allows fungi to grow
Appear as discolored flaky patches on the skin
The color of the patches will change with sun exposure
Treatment with dandruff medications or anti-fungals
Commonly affected areas: chest, back, upper arm, neck
Skin pigmentation changes may last after fungus is treated

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Pathogenesis: Pityriases Folliculitis

Localized papules, pimple,

and pustules often show up
after sun exposure
Hair follicles become
infected and inflammed by
the fungi Pityrosporum
orbiculare (more severe
condition of pityriasis
versicolor)
Common in hot, humid
tropical climates where UV
rays are stronger
Heat & friction irritates
follicles

(image courtesy of http://infections.consultantlive.com/

display/article/1145625/1394106)

http://
www.mycology.adelaid
e.edu.au/Mycoses/
Superficial/
Malassezia_infections/)

Opportunistic
systematic infection
Infection in newborns
Presence of venous
catheters
Prolonged
hospitalization
Most common in
patients receiving lipid
replacement therapy
(helps increase weight)

Pathogenesis
Acne Vulgaris
More commonly known as
acne
Whiteheads, blackheads,
pimples, pustules
When follicles in skin
become clogged
Swelling and inflammation

(Image courtesy of

Pathogenesis: Catheter-Related Fungemia in

Neonates

Pathogenesis: Seborrheic Dermatitis

Often chronic and

undiagnosed for years
Occurs mostly in immunocompromised patients and
diabetics
Mild cases treated with
imidazole
More severe casesketoconazole or
itraconazole (all are antifungals)

Chronic (life-long) condition

More commonly known as
dandruff
May affect scalp and inner ear
M.Yamatoensis
Not due to poor hygiene
Inflammatory skin conditions
Scale color varies depending
Known as cradle cap when
on environmental conditions
(Image courtesy of http://www.dermatitisseborrheic.net/ &
appears in infants
http://emedicbuzz.com/tag/seborrheic-dermatitis/)
White-yellowish scales appear on
or near oily areas of skin
This condition can run in families
and appear more commonly in
patients with neurological
conditions and immune
compromised

Pathogenesis: Atopic Dermatitis

M. globosa and M. restricta

cause the condition
Stays inflammed for a long
period of time
May be blisters or red
irritated skin that crusts over
Sometimes ear discharge or
bleeding may occur
According to the American
Society for Microbiology,
patients with atopic
dermatitis produce Malassezia
specific immunoglobulin E
(IgE) whereas healthy patients
do not

Furthermore anti-fungals can

improve symptoms of atopic
dermatitis
(images courtesy of http://prescriptionworld.org/ and
http://www.cssd.us/body.cfm?id=499)

Pathogenesis
Dacrocystitis

Inflammation of the
lacrimal sac in the inner
ear
Redness and discharge
(Images courtesy http://www.eyesurgeononline.com/
services.html & http://www.getacnehomeremedies.info)

Seborrheic Blepharitis

Chronic inflammation of
the eyelid
Burning, sensitivity,
irritation, blurred vision

Psoriasis

(image from http://www.e-psoriasis.com/app/

diagnosis.asp)

Age 15-35
Skin infection and
irritation
Have red skin with yellow
flaky scales
Severe in people with
weak immune system
Some types genetic, some
caused from fungus

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Pathogenesis
Onchyomycosis

Nail infection
Athlete's foot, jock itch,
ringworm
Need heat and humidity

(image from http://www.myfootshop.com)

Case Study
Confluent & Reticulated
Papillomatosis

Skin infection on the trunk

or chest
Forms brown scaly papules
over skin

Clinical Aspects of Patients

with Pityriasis Versicolor
at a Tropical Center for
Dermatology

(images from http://www.dermis.net)

Subjects were not

allowed to use any type
of medication within 30
days of study.
All had a positive direct
mycological examination
and filled out questionaire
to aid in why and how
people become infected

Malassezia spp. Originally

found M. furfur to be the
only causative agent, now
13 species in Malassezia
genus.
Study used 116 subjects:
varying in age, race,
gender, skin type,
occupation, and clinical
features of disease
Image from: health.allrefer.com

Case Study: Findings and Factors

Most commonly affected ages: 10-20 (33.6%=39/116)

Case Study: Involvement

Resulting from greater development of sebaceous gland, which

produce more sebum (oil)

Found higher frequency in males in this study (others

have showed no predominance in genders)
Race and occupation had little to no relevance
Factors involved: genetic inheritance, elevated
temperatures, humidity, use of oils/moisturizers,
immunosuppression, malnutrition, and chemical
composition of sebum.

Most common areas

affected are: Trunk and
upper limbs
Degree of involvement
was more commonly
extensive (4 or more
regions)

Table from Anais Brasileiros de DermatologiaversionISSN 0365-0596

Case Study: Treatment

Most commonly and
effective were
combination of topical
and oral medications
Including keratolytic
and azolic antifungal
agents
Recurrence are
frequent
Can become chronic
without treatment

References

Aly, R. et al. "Malassezia spp.." DoctorFungus.

N.p., n.d. Web. 08 Jul 2011. <http://
www.doctorfungus.org/thefungi/
malassezia.php>.

Armstrong, D., F. F. Edwards, T. E. Kiehn, A. E.

Brown, and G. R. Garber. "Catheter-related
Malassezia Furfur Fungemia in
Immunocompromised Patients." The American
Journal of Medicine 95.4 (1993): 365-70.
PubMed.gov. Web. 12 July 2011.

Berman, Kevin. "Psoriasis - PubMed

Health." National Center for Biotechnology
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<http://www.ncbi.nlm.nih.gov/pubmedhealth/
PMH0001470/>.

Image from members.kaiserpermanente.org

Berman, Kevin. "Seborrheic Dermatitis PubMed Health." National Center for

Biotechnology Information. Web. 13 July 2011.
<http://www.ncbi.nlm.nih.gov/pubmedhealth/
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"Blepharitis-PubMed Health." National Center
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Cohen, Bernard A. "DermAtlas: Online

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"Malassezia Fungemia in Neonates and Adults:
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Morias, Patrcia Motta de; CUNHA, Maria da
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Clinical aspects of patients with pityriasis
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<http:www.scielo.brscielo.phpscript>
Oakley, Amanda. "Pityriasis Versicolor (tinea
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fungal/pityriasis-versicolor.html>.

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References

"Pityriasis Versicolor." NetDoctor.co.uk The UK's Leading Independent Health

Website. Ed. John Pillinger. 10 June 2008.
Web. 11 July 2011. <http://
www.netdoctor.co.uk/ diseases/facts/
pityriasisversicolor.htm>.
"Seborrheic Dermatitis: MedlinePlus
Medical Encyclopedia." National Library of
Medicine - National Institutes of Health.
Ed. Kevin Berman. Merican Accreditation
HealthCare Commission, 18 July 2007.
Web. 11 July 2011. <http://
www.nlm.nih.gov/medlineplus/ency/article/
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Sugita, Takashi, Mami Tajima, Hisae
Tsubuku, and Ryoji Tsuboi Akemi
Nishikawa. "A New Calcineurin Inhibitor,
Pimecrolimus, Inhibits the Growth of
Malassezia spp. ." Antimicrobial Agents
and Chemotherapy 50.8 2897-2898. Web.
11 Jul 2011. <http:// aac.asm.org/cgi/
content/full/50/8/2897>.

Vordick, Linda J. "Atopic Eczema PubMed Health." National Center for

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PMH0002306/>.
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