Übersichtsarbeit


Malassezia beyond tinea versicolor: the newest wolf in sheep’s clothing pathogen?

Malassezia jenseits Tinea versicolor: das neueste Pathogen als Wolf im Schafspelz?

Keywords | Summary | Correspondence | Literature

Keywords

Schlüsselworte

Summary

Malassezia (M) yeasts are lipophilic commensals and part of the healthy human skin flora, although they may play a role as opportunistic cutaneous pathogens, being a well-known cause of pityriasis versicolor (PV), the prototypical Malassezia-associated skin infection. Recent data has shown new pathogenic potential of Malassezia which under insufficiently understood conditions may be implicated in exacerbations of inflammatory dermatoses, especially on a clinical variant of atopic dermatitis (AD) and some other dermatological and systemic diseases previously unrelated to this yeast. Although there is no evidence that Malassezia species invade the skin, there actually is evidence that their antigens might penetrate a previously damaged epidermis and interact with cells that take part in the skin’s immune system, thus inducing the production of a variety of cytokines which may trigger flares of certain dermatoses. The purpose of this article is to discuss clinical cases reflecting the spectrum of pathogenic interactions of Malassezia fungus with human skin.

Zusammenfassung

Malassezia (M)- Hefen sind lipophile Kommensalen und Teil der Flora der gesunden Haut. Anderseits spielen sie eine Rolle als opportunistische kutane Pathogene wie bei der prototypischen M-Infektion der Haut, der Pityriasis versicolor. Rezente Daten zeigen neue Aspekte des pathogenetischen Potentials von M, z.B. bei der Exazerbation entzündlicher Dermatosen, z.B. bei klinischen Varianten des atopischen Ekzems sowie einiger anderer Dermatosen und Systemerkrankungen. Obwohl es keine Daten gibt, die eine Invasion von M-Spezies in die Haut belegen, können Antigene durch eine geschädigte Haut penetrieren und mit Immunzellen in Wechselwirkung treten. Dieser Umstand könnte die Freisetzung von Zytokinen auslösen, welche die Exazerbation vom Dermatosen triggern könnten. In diesem Artikel werden wir klinische Fälle diskutieren, die das klinische Spektrum pathogener Wechselwirkungen von M mit humaner Haut illustrieren sollen.

Leider haben Sie sich nicht eingeloggt, um den Beitrag lesen zu können. Bitte loggen Sie sich ein oder beantragen Sie Ihre Zugangsberechtigung. Vielen Dank. Weitere Informationen finden Sie hier>

Korrespondenz-Adresse

César Bimbi, MD
R. 24 de Outubro
111 - Sala 502 – Independência
Porto Alegre – RS
BR-90510-002
cbimbi@terra.com.br

Conflict of Interests

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Literatur

1. Theelen B, Cafarchia C, Gaitanis G, Bassukas ID, Boekhout T, Dawson TL Jr. Malassezia ecology, pathophysiology, and treatment. Med Mycol. 2018;56(Suppl 1):S10-S25. Erratum in: Med Mycol. 2019;57(3):e2.
2. Saunte DML, Gaitanis G, Hay RJ. Malassezia-associated skin diseases, the use of diagnostics and treatment. Front Cell Infect Microbiol. 2020; 10:112.
3. Ashbee HR, Evans EG. Immunology of diseases associated with Malassezia species. Clin Microbiol Rev. 2002;15(1):21-57.
4. Meason-Smith C, Olivry T, Lawhon SD, Hoffmann AR. Malassezia species dysbiosis in natural and allergen-induced atopic dermatitis in dogs. Med Mycol. 2020;58(6):756-765.
5. Yu HJ, Lee SK, Son SJ, Kim YS, Yang HY, Kim JH. Steroid acne vs. Pityrosporum folliculitis: the incidence of Pityrosporum ovale and the effect of antifungal drugs in steroid acne. Int J Dermatol. 1998;37(10):772-777.
6. Cohen PR, Erickson C, Calame A. Malassezia (Pityrosporum) folliculitis incognito: Malessezia-associated folliculitis masked by topical corticosteroid therapy. Cureus. 2020;12(1):e6531.
7. Levy JM, Magro C. Atrophying pityriasis versicolor as an idiosyncratic T cell-mediated response to Malassezia: A case series. J Am Acad Dermatol. 2017;76(4):730-735.
8. Guglielmo A, Sechi A, Patrizi A, Gurioli C, Neri I. Head and neck dermatitis, a subtype of atopic dermatitis induced by Malassezia spp: Clinical aspects and treatment outcomes in adolescent and adult patients. Pediatr Dermatol. 2021;38(1):109-114.
9. Åberg L, Varjonen K, Åhman S. Results of allergen-specific immunotherapy in atopic dogs with Malassezia hypersensitivity: a retrospective study of 16 cases. Vet Dermatol. 2017;28(6):633-e157.
10. Buentke E, Heffler LC, Wilson JL, Wallin RP, Löfman C, Chambers BJ, Ljunggren HG, Scheynius A. Natural killer and dendritic cell contact in lesional atopic dermatitis skin - Malassezia-influenced cell interaction. J Invest Dermatol. 2002;119(4):850-857.
11. Hiragun T, Ishii K, Hiragun M, Suzuki H, Kan T, Mihara S, Yanase Y, Bartels J, Schröder JM, Hide M. Fungal protein MGL_1304 in sweat is an allergen for atopic dermatitis patients. J Allergy Clin Immunol. 2013;132(3):608-615.e4.
12. Matsumoto Y, Harada K, Maeda T, Egusa C, Hirano H, Okubo Y, Tsuboi R. Molecular detection of fungal and bacterial DNA from pustules in patients with palmoplantar pustulosis: special focus on Malassezia species. Clin Exp Dermatol. 2020;45(1):36-40.
13. Gaitanis G, Velegraki A, Magiatis P, Pappas P, Bassukas ID. Could Malassezia yeasts be implicated in skin carcinogenesis through the production of aryl-hydrocarbon receptor ligands? Med Hypotheses. 2011;77(1):47-51.
14. Gaitanis G, Magiatis P, Hantschke M, Bassukas ID, Velegraki A. The Malassezia genus in skin and systemic diseases. Clin Microbiol Rev. 2012;25(1):106-141.
15. Lam S, Zuo T, Ho M, Chan FKL, Chan PKS, Ng SC. Review article: fungal alterations in inflammatory bowel diseases. Aliment Pharmacol Ther. 2019;50(11-12):1159-1171.
16. Aykut B, Pushalkar S, Chen R, Li Q, Abengozar R, Kim JI, Shadaloey SA, Wu D, Preiss P, Verma N, Guo Y, Saxena A, Vardhan M, Diskin B, Wang W, Leinwand J, Kurz E, Kochen Rossi JA, Hundeyin M, Zambrinis C, Li X, Saxena D, Miller G. The fungal mycobiome promotes pancreatic oncogenesis via activation of MBL. Nature. 2019;574(7777):264-267.
17. Huang CY, Peng CC, Hsu CH, Chang JH, Chiu NC, Chi H. Systemic infection caused by Malassezia pachydermatis in infants: case series and review of the literature. Pediatr Infect Dis J. 2020;39(5):444-448.

Ausgabe