Malassezia (Pityrosporon) Folliculitis Occurring During Pregnancy

A 23-year-old pregnant woman in her 37th week presented with a pruritic rash that had persisted for 4 months, characterized by erythematous papules and pustules on her neck, trunk, and proximal extremities. The rash did not respond to topical benzoyl peroxide gel. Histopathologic examination revealed plugged hair follicles with keratinaceous material, inflammatory cells, and yeast-like organisms, identified as Malassezia (Pityrosporon) without hyphal forms. The patient had a history of mild acne treated with benzoyl peroxide, tretinoin, and tetracycline, which was discontinued upon pregnancy. She was otherwise healthy and not on systemic medications during her pregnancy.