Malassezia Folliculitis: A Review Article

Malassezia folliculitis (MF) results from overgrowth of Malassezia yeasts, which are normal skin flora. This condition is caused by a loss of balance between Malassezia yeasts, microenvironment, and human immunity. MF presented as small, monomorphic, itchy papules, and pustules particularly on hair line, face, and upper trunk. Because the appearance and location of MF are similar to acne, this makes it difficult to distinguish between the two conditions. MF is an under-recognized disease that is often misdiagnosed as acne vulgaris, recalcitrant acne, neonatal cephalic pustulosis or neonatal acne, and steroid acne. In addition, MF can occur simultaneously with acne vulgaris. The definite diagnosis is based on clinical presentations, direct microscopy, histopathological examination, and good response to antifungal treatments. MF may persist for years without complete resolution with standard acne treatment. Dermatologists should be aware of this disease when encountering patients with acne problems to provide proper management. Keywords: Malassezia folliculitis; Acne vulgaris; Recalcitrant acne; Neonatal acne; Steroid acne