Clinical characteristics and treatment outcomes of Pityrosporum folliculitis in immunocompetent patients

Abstract

Pityrosporum folliculitis (PF) is a fungal acneiform disease of the hair follicles that often presents with pruritic papules and pustules on the upper body and face . This condition is commonly mistaken for acne vulgaris and can be distinguished from bacterial acne by the presence of fungal spores in the follicular lumen . Although studies have been performed to describe PF in cohorts, little work has been done to aggregate these data. Thus, the goal of this review is to describe the clinical characteristics and treatment outcomes of PF in immunocompetent patients. PubMed, Web of Science, and Embase were searched using the terms “Pityrosporum folliculitis” or “Malassezia folliculitis.” All cohorts reporting PF characteristics in patients classified as immunocompetent were reviewed. A total of 15 studies were included. Majority of patients were male (64%) with the average age of presentation of 24.26 years. The most common locations of lesions were the chest (70%) and back/shoulders (69.2%). Pruritus was reported by the majority of patients (71.7%). Additionally, 40.5% of patients reported a history of unsuccessful treatment regimens. Treatment was most successful with an oral antifungal (92%), followed by a topical antifungal (81.6%). In conclusion, majority of patients with PF were younger males. Many patients were primarily treated incorrectly, suggesting the importance of proper diagnosis. PF may be distinguishable from acne vulgaris by the presence of pruritus or suggested when a new acneiform eruption develops following antibiotic therapy or immunosuppression. When properly diagnosed, majority of cases of PF achieve complete response with oral or topical antifungals.

UV Dermoscopy for the Diagnosis of Pityrosporum Folliculitis

“…PF is a cutaneous condition secondary to infection of the hair follicle by fungi of the genus Malassezia spp [ 1 ]. This fungus has enzymes, such as lipases and phospholipases, capable of hydrolyzing triglycerides into fatty acids, thereby promoting follicular occlusion [ 1 ].…”

“…PF is a cutaneous condition secondary to infection of the hair follicle by fungi of the genus Malassezia spp [ 1 ]. This fungus has enzymes, such as lipases and phospholipases, capable of hydrolyzing triglycerides into fatty acids, thereby promoting follicular occlusion [ 1 ]. PF has a universal distribution, predominantly affects young adults, and is associated with antibiotic therapy, diabetes mellitus and immunosuppressants [ 1 ].…”