Efficacy and Safety of Cream Containing Climbazole/Piroctone Olamine for Facial Seborrheic Dermatitis: A Single-Center, Open-Label Split-Face Clinical Study

BACKGROUND: Seborrheic dermatitis (SD) is a multifactorial disease; Malassezia species play an important role in its pathogenesis. OBJECTIVE: We aimed to determine whether a cream containing climbazole/piroctone olamine (C/P cream), antifungal agents with expected efficacy against Malassezia species, could improve SD symptoms. METHODS: We instructed 24 patients with mild-to-moderate SD to apply the C/P cream and emollient cream on the right and left sides of the face, respectively, every morning and evening for 4 weeks. The casual sebum level (measured with Sebumeter®; Courage & Khazaka Electronic GmbH, Germany) and the extent of erythema (measured with Mexameter®; Courage & Khazaka Electronic GmbH) on the face were measured at baseline and after 4 weeks. The minimal inhibitory concentration (MIC) was determined to demonstrate the antifungal activity of the C/P cream. RESULTS: The casual sebum level and erythema were measured at week 4, and the median values demonstrated a quantitative improvement on the C/P cream-treated right side of the face compared to the emollient cream-treated left side. For the C/P cream, the MICs were 0.625, 5, 0.625, and 2.5 mg/ml for Malassezia restricta, M. globosa, M. sympodialis, and M. slooffiae, respectively. CONCLUSION: Based on the reduced casual sebum level and extent of erythema, the antifungal activity of C/P cream against Malassezia species seems useful for the treatment of mild to moderate SD.

Difference of Malassezia Species and Pityrosporum ovale Specific IgE in Head and Neck Lesions of Atopic Dermatitis Related to Ages and Severity / 대한의진균학회지

BACKGROUND: Members of the genus Malassezia, lipophilic yeasts, are considered to be one of the exacerbating factors in atopic dermatitis. When the response of anti-inflammatory treatment of atopic dermatitis to adults was poor, antifungal treatment had a good response to atopic dermatitis. We compared Malassezia species detected in head and neck lesions of atopic dermatitis between children and adults. OBJECTIVE: To compare Malassezia species between children and adults in head and neck lesions of atopic dermatitis and to reveal the correlation levels of P. ovale specific IgE and clinical severity among these groups. METHODS: Malassezia species were incubated in Leeming and Notman media from skin lesions of 28 patients with head and neck lesions of atopic dermatitis (13 children, 15 adults). And ITS1 amplification and sequencing method was done for detection of Malassezia species. We also assayed P. ovale specific IgE and clinical severity grade of the patients. RESULTS: M. globosa was the predominant species in the children group. And M. furfur was the predominant species in the adults group respectively. The levels of P. ovale specific IgE increased more in the adults group than the children group. Clinical severity grade also more increased in the adults group. There was statistically significant correlation between P. ovale specific IgE and clinical severity grade (p<0.001). Conclusion: Malassezia species are aggravating factors in head and neck lesions of atopic dermatitis particularly in adults. We must keep in mind Malassezia species infection when resistance to antiinflammatory therapy in atopic dermatitis of adults.

Malassezia Species Cultured from the Lesions of Malassezia Folliculitis / 대한의진균학회지

BACKGROUND: The yeasts of genus Malassezia are dimorphic and lipophilic and are numbers of the normal flora in humans. Malassezia yeasts are implicated in various diseases, including pityriasis versicolor, Malassezia folliculitis, seborrheic dermatitis and systemic fungal infections. OBJECT: The study was done to classify the Malassezia yeasts cultured from the lesions of Malassezia folliculitis into one of the revised species and to find out the relationship between certain species of Malassezia and Malassezia folliculitis. METHODs: The specimen obtained from the lesions of twenty cases of Malassezia folliculitis and twenty cases of healthy controls were cultured on Leeming & Notman's media. The obtained strains were placed into one of the seven species by their colony morphologies, microscopic morphologies and physiological characteristics. RESULTS: In the lesions of Malassezia folliculitis, M. globosa occupied most of the cultured colonies in 15 cases, M. restricta in 4 cases and M. furfur in 1 case respectively. In the control group, M. restricta was found to be predominant on the face and M. sympodialis, M. globosa, M. restricta and M. furfur were isolated on the trunk. CONCLUSION: M. restricta and M. globosa could be considered to be mostly implicated species in the seven revised Malassezia species in the lesions of Malassezia folliculitis of the face and trunk respectively.

The Distribution of Malassezia Species on the Normal Human Skin According to Body Region / 대한의진균학회지

BACKGROUND: The seven species Malassezia yeasts are recognized in the genus Malassezia (M.). These species can be isolated from the normal skin of warm-blooded animals including humans and various dermatoses. In Korea, most surveys of Malassezia yeast distribution have been performed without classifying the genus Malassezia into the species. OBJECTIVE:The aim of this work was to study the qualitative distribution of the Malassezia species on the normal human skin to provide a basic data for a study of Malassezia species in patients with various dermatoses. METHODS: The Malassezia yeasts were cultured from clinically normal skin at four sites in 37 subjects. The isolated yeasts were identified into the species level using the cell types and physiological properties of the species. RESULTS: Six species of the genus Malassezia, M. furfur, M. sympodialis, M. globosa, M. Obtusa, M. restricta and M. slooffiae, were isolated. M. restricta was found to be predominant on the forehead and scalp. M. globosa was found to be predominant on the chest and back. The incidence of Malassezia yeasts was 78.4% on the scalp, 86.5% on the forehead, 100% on the chest and 97.3% on the back. CONCLUSION: The results showed a regional variation in the distribution of M, restricta and M, globosa. The information obtained from this study would be of great value in the evaluation of the role of Malassezia species in related diseases.

Malassezia Species Cultured from the Lesions of Pityriasis Versicolor / 대한피부과학회지

BACKGROUND: The genus Mulassezia. was recently revised into seven species, M. furfur, M pachydermatis, M sympodialis, M. globosa, M. obtusa, M. restricta and M. slooffiae. Some of the Malassezia species were known to be the etiological agent of pityriasis versicolor. OBJECTIVE: The study was done to place the Malassezia strains cultured from the lesions of pityrisis versicolor into one of The revised species and to elucidate the relationship between certain species and pityriasis versicolor. METHODS: The scales from the lesions of twenty cases of pityrisis versicolor were cultured on Leeming & Notmans media. The obtained strains were placed into one of seven species by their colony morphologies, microscopic morphologies and physiological characteristics. RESULTS: The strains obtained from twenty cases of pityriasis ver sicolor could be placed into one of four species as following incidences. 1 case of M. furfur, 3 cases of M. sympodialis, 15 cases of M globosa, 1 case of M. obtusa, M, globoso occupied the most commonly isolated species cultured from the lesions of pityriasis versicolor. CONCLUSION: The results suggested that M. globosa could be consider ed as a main etiological agent of pityriasis versicolor among the Malassezia species.