Evaluation and Treatment of Malassezia-Related Skin Disorders

Malassezia are commensal yeasts found on the sebaceous areas of human skin. Although they are part of the normal skin flora, they play a pathogenic role in several skin conditions, most notably tinea versicolor, Pityrosporum folliculitis, and seborrheic dermatitis. Malassezia also have been associated with subsets of psoriasis and atopic dermatitis, especially those affecting the scalp. Patients are often distressed by the appearance of Malassezia-related diseases, particularly the dyspigmentation of tinea versicolor and the scaling and erythema of seborrheic dermatitis and scalp psoriasis. Treatment of Malassezia-related dermatoses generally requires the use of topical or oral antifungal medications, often in combination with antifungal washes and shampoos. In some cases, low-potency corticosteroids are a useful adjunct. Patients with Malassezia dermatoses need to be educated on the tendency of these eruptions to recur unless maintenance treatment is continued indefinitely. The appearance of skin affected by Malassezia may take months to normalize, even after successful treatment.