Atypical Folliculitis Caused by Malassezia spp. in Immunosuppressed Patients

    Eduardo Marín-Hernández, Ciara G Mejía-Mancera, Miguel A Quijada-Henderson, Alfredo Valero-Gómez
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    TLDR Some immunosuppressed patients can get unusual skin infections from Malassezia, which can be treated with antifungal medication.
    The document reports on two cases of atypical folliculitis caused by Malassezia spp. in immunosuppressed patients, a 14-year-old with chondroid osteosarcoma and a 16-year-old with synovial sarcoma, both presenting with unusual papulopustular lesions during hospitalization for fever and neutropenia. Diagnosis was challenging due to the atypical presentation in non-seborrheic areas and was confirmed through biopsy and direct examination. The study underscores the importance of considering Malassezia folliculitis in immunosuppressed patients with non-classical symptoms and utilizing appropriate diagnostic methods to confirm the etiology. Treatment with itraconazole was effective for both patients, and the document also discusses the broader context of Malassezia infections, including potential fatality in cases like fungemia in preterm neonates, and the necessity of both topical and oral antifungals depending on the severity and spread of the infection.
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