Tinea Versicolor: Susceptibility Factors and Experimental Infection in Human Beings*

Burke, Ruth C.

doi:10.1038/jid.1961.60

Cited by 153 publications

(81 citation statements)

References 15 publications

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“…The condition occurs mainly between adolescence and middle age, when the sebaceous glands are more active (134), although it has also been reported in children (11,93,284,479) and the elderly (109,285). Predisposing factors include a "genetic susceptibility" (77,175), illness or malnutrition (77), increased plasma cortisol level (57,77,237), and high ambient temperature and humidity (127). The incidence in temperate climates is around 1% (134,183), but incidences as high as 40 to 60% have been reported in tropical climates (209).…”

Section: Pityriasis Versicolormentioning

confidence: 99%

Immunology of Diseases Associated withMalasseziaSpecies

2002

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SUMMARY Malassezia species are members of the human cutaneous commensal flora, in addition to causing a wide range of cutaneous and systemic diseases in suitably predisposed individuals. Studies examining cellular and humoral immune responses specific to Malassezia species in patients with Malassezia-associated diseases and healthy controls have generally been unable to define significant differences in their immune response. The use of varied antigenic preparations and strains from different Malassezia classifications may partly be responsible for this, although these problems can now be overcome by using techniques based on recent work defining some important antigens and also a new taxonomy for the genus. The finding that the genus Malassezia is immunomodulatory is important in understanding its ability to cause disease. Stimulation of the reticuloendothelial system and activation of the complement cascade contrasts with its ability to suppress cytokine release and downregulate phagocytic uptake and killing. The lipid-rich layer around the yeast appears to be pivotal in this alteration of phenotype. Defining the nonspecific immune response to Malassezia species and the way in which the organisms modulate it may well be the key to understanding how Malassezia species can exist as both commensals and pathogens.

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Section: Pityriasis Versicolormentioning

confidence: 99%

Immunology of Diseases Associated withMalasseziaSpecies

2002

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“…Burke observed typical structures of M. furfur in a patient experimentally infected with P. orbiculare; she also was able to produce hyphal elements in cultures of this organism (20). Keddie and Shadomy isolated P. orbiculare from scales of patients with pityriasis versicolor in which the presence of M. furfur had been demonstrated by staining and direct microscopic examination (72).…”

Section: Historical Perspectivementioning

confidence: 99%

Human infections due to Malassezia spp

1992

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The genus Malassezia contains three member species: Malassezia furfur and Malassezia sympodialis, both obligatory lipophilic, skin flora yeasts of humans, and Malassezia pachydermatis, a nonobligatory lipophilic, skin flora yeast of other warm-blooded animals. Several characteristics suggest the basidiomycetous nature of these yeasts, although a perfect stage has not been identified. Classically, these organisms are associated with superficial infections of the skin and associated structures, including pityriasis versicolor and folliculitis. Recently, however, they have been reported as agents of more invasive human diseases including deep-line catheter-associated sepsis. The latter infection occurs in patients, primarily infants, receiving parenteral nutrition (including lipid emulsions) through the catheter. The lipids presumably provide growth factors required for replication of the organisms. It is unclear how deep-line catheters become colonized with Malassezia spp. Skin colonization with M. furfur is common in infants hospitalized in neonatal intensive care units, whereas colonization of newborns hospitalized in well-baby nurseries and of older infants is rarely observed. Catheter colonization, which may occur without overt clinical symptoms, probably occurs secondary to skin colonization, with the organism gaining access either via the catheter insertion site on the skin or through the external catheter hub (connecting port). There is little information on the colonization of hospitalized patients by M. sympodialis or M. pachydermatis. Diagnosis of superficial infections is best made by microscopic examination of skin scrapings following KOH, calcofluor white, or histologic staining. Treatment of these infections involves the use of topical or oral antifungal agents, and it may be prolonged. Diagnosis of Malassezia catheter-associated sepsis requires detection of the organism in whole blood smears or in buffy coat smears of blood drawn through the infected catheter or isolation of the organism from catheter or peripheral blood or the catheter tip. Culture of M. furfur from blood is best achieved with Isolator tubes and plating onto a solid medium supplemented with a lipid source. Appropriate treatment of patients requires removal of the infected catheter with or without temporary stoppage of lipid emulsions; administration of antifungal therapeutic agents does not appear to be necessary. Because many patients who develop Malassezia catheter-associated sepsis have severe underlying illnesses, caution must be exercised in attributing all clinical deterioration to Malassezia infection. Our better understanding of how these organisms cause disease awaits the development of a useful typing scheme for epidemiologic studies and further studies on microbial virulence factors and the role of the immune response in pathogenesis.

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“…This conclusion is based upon several lines of evidence: (a) by using the proper media, the organisms can be readily cultivated from scrapings of tinea versicolor lesions; (b) the cultured organisms can form germ tubes in culture (6,9,10); (c) specific antisera to cultured P. orbiculare organisms have been found to react with the fungal elements in scrapings of tinea versicolor lesions (11); and (d) experimental tinea versicolor infections have been produced in humans through inoculation of cultured P. orbiculare (12). However, although this organism appears to produce tinea versicolor, it is commonly found on the skin of normal individuals (3,4,9).…”

Section: Introductionmentioning

confidence: 99%

Cell-Mediated Immunity to Pityrosporum Orbiculare in Tinea Versicolor

Sohnle¹,

Lech²

1978

J. Clin. Invest.

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A B S T R A C T Pityrosporum orbiculare, the presumed etiologic agent of tinea versicolor, was cultured in vitro and antigenic extracts prepared from the cultured organisms. Studies with lymphocytes from human cord blood and peripheral blood of guinea pigs demonstrated that such extracts were not mitogenic. Further studies in guinea pigs indicated that the animals could be sensitized by the injection of P. orbiculare extract in Freund's complete adjuvant and that this extract could elicit lymphocyte transformation and delayed skin test responses in sensitized animals.A group of 12 tinea versicolor patients and 15 normal subjects were studied in vitro for cell-mediated immunity to P. orbiculare extract. The majority of the subjects tested in both groups demonstrated positive lymphocyte transformation responses to this extract, as well as to standard mitogens and common microbial antigens. However, lymphocytes from tinea versicolor patients produced significantly less leukocyte migration inhibitory factor activity when stimulated by Candida albicans and P. orbiculare extracts than did lymphocytes from normal subjects. This was also true if only subjects with positive lymphocyte transformation responses to these antigens were considered. Leukocyte migration inhibitory factor responses to streptokinase/streptodornase were not significantly different between the two groups. Therefore, it appears that although both normal subjects and tinea versicolor patients demonstrate prior sensitization to antigens of P. orbiculare, the effector function of lymphocytes from most tinea versicolor patients appears to be impaired in that they produce subnormal amounts of the mediator leukocyte migration inhibitory factor when stimulated with antigenic extracts of this organism.

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Tinea Versicolor: Susceptibility Factors and Experimental Infection in Human Beings*

Cited by 153 publications

References 15 publications

Immunology of Diseases Associated withMalasseziaSpecies

Immunology of Diseases Associated withMalasseziaSpecies

Human infections due to Malassezia spp

Cell-Mediated Immunity to Pityrosporum Orbiculare in Tinea Versicolor

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