Pityrosporum Folliculitis: A Case Report.
Pityrosporum (Malassezia) folliculitis (PF) was first described by Weary et al in1969.
PF is a afungal infection of the hair follicles caused by Malassezia yeasts.
Malassezia yeasts are normal flora of the skin that under certain circumstances become pathogenic
and lead to an inflammatory reaction in the skin.
PF is characterized clinically by symmetrical monomorphic follicular 1-3 mm erythematous
papules and pustules that present mainly on the chest, shoulders, neck and less commonly on the head.
It is more common in females. The differential diagnosis of pityrosporum folliculitis includes chicken pox,
steroid acne, herpes simplex virus, acute generalized exanthematous pustulosis, and pustular psoriasis.
Treatment of PF includes topical agents (e.g) (econazole solution, selenium sulfide shampoo
and systemic agents (e.g) (fluconazole). Isotretinoin and photodynamic therapy have also been
used in small case series.
Twenty-one-years old healthy male presented with 2-weeks history of persistent itchy skin lesions.
Past medical history, family history,
and review of symptoms were all unremarkable. No history of
drug intake. Skin examination revealed extensive multiple monomorphic papules and pustules
with erythematous hallow on his forehead, chest, back, neck and upper arms (Figure 1).
Hair, nails and mucous membranes were normal. Skin smear from a pustule
for potassium hydroxide (KOH) was negative for hyphae and yeast.
The skin lesions disappeared 2-weeks after starting the patient on ketoconazol shampoo
once daily plus oral fluconazole 100 mg cap once daily (Figure 2). On the basis of the above
clinical findings, a diagnosis of pityrosporum folliculitis was made.
Dermatol Open J. 2019; 3(1): 17-18. doi: 10.17140/DRMTOJ-3-132