What is malassezia folliculitis?
Malassezia folliculitis, previously known as pityrosporum folliculitis, is an infection of hair follicles caused by lipophilic malassezia yeasts. There are multiple malassezia species, including furfur, globosa, sympodialis and restricta . The yeast is a normal inhabitant of human skin and only causes disease under specific conditions .
Who gets malassezia folliculitis?
Malassezia folliculitis is most commonly seen in adolescent and young adult males living in humid climates [3,4]. Other risk factors include:
- High sebum production [3,4]
- Hyperhidrosis (excessive sweating) [3,4]
- Occlusion from emollients and sunscreens
- Antibiotic use 
- Oral steroids such as prednisone (steroid acne)
- Immunosuppression .
How does malassezia folliculitis present?
Malassezia folliculitis presents as small uniform itchy papules and pustules on the forehead, chin, neck, trunk and extensor aspect of the upper limbs. They may be itchy.
How is malassezia folliculitis diagnosed?
Clinical examination is usually sufficient for diagnosis. Laboratory investigations may be performed.
- Potassium hydroxide preparation of skin scrapings may reveal budding spores and hyphae .
- Other stains, including the May-Grunwald-Giema stain may also be helpful, but are less commonly used .
- Cultures are not routinely done, as malassezia species typically require special media for growth.
Treatment of malassezia folliculitis
It is important to address any predisposing factors at the outset, as malassezia folliculitis has a tendency to recur.
Topical agents (eg, selenium sulfide shampoo, econazole solution) may also be used but should be reserved for those unable to tolerate oral treatment [9,10].
Prevention of malassezia folliculitis
Recurrence is common, even after successful treatment .
Long-term prophylaxis with topical agents may be considered in those at high-risk or with multiple recurrences.
Periodic re-evaluation of predisposing factors is recommended.