https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(04)17107-9.pdf

Superficial fungal infections.

To investigate the distribution of Malassezia species on four body sites (scalp, forehead, chest and back), we employed contact plates filled with Leeming–Notman agar to sample 245 clinically healthy subjects, representing six age groups (AG) (AG I, 0–3 years; AG II, 4–14 years; AG III, 15–25 years; AG IV, 26–40 years; AG V, 41–60 years; AG VI, over 60 years). The number of colony forming units was recorded for every plate positive for Malassezia species, and the species were identified. Younger individuals (<14 years) yielded a culture positive for Malassezia significantly less frequently than did older individuals (≥15 years). M. globosa was cultured at significantly elevated frequency on younger subjects. M. sympodialis was present at low frequency on younger subjects, but was found in higher amounts on the skin of adolescents and adults. The amount and kind of Malassezia species that can be recovered from human skin varies with age and body site.

Prevalence of Malassezia species on various body sites in clinically healthy subjects representing different age groups

BACKGROUND: Pityriasis versicolor (PV) is a mild chronic infection of the skin caused by Malassezia yeasts. Although it is primarily seen in adults, children are often affected in the tropics . METHODS: Over a period of 2 years, children (up to the age of 14 years) who were clinically and mycologically diagnosed as PV were included in the study. The clinical and epidemiological pattern in different age groups was noted. RESULTS: PV in this age group formed about 31% of the total cases of PV; 4.8% cases presented in infancy. The commonest site of involvement was the face in 39.9% of the cases. Most of the cases presented in summer months. CONCLUSIONS: PV is not an uncommon disease among children in the tropics. There is a sudden resurgence of cases in the hot monsoons and even infants are not spared.

Pityriasis versicolor in the pediatric age group.

Malassezia furfur is a lipodependent, dimorphic and saprophyte fungus which causes pityriasis versicolor, dandruff and seborrheic dermatitis in humans. The drugs available to treat this fungal infection are few. These drugs are highly toxic and are costly when used in prolonged treatments. For these reasons, it is necessary to find new compounds to treat these infections. Ilex paraguariensis St Hilaire is a plant that grows in Argentina, Brazil and Paraguay. The aim of this study was to evaluate the effect of the aqueous extract of Ilex paraguariensis on the growth of M. furfur. High performance liquid chromatography (HPLC) was employed to identify and isolate compounds of I. paraguariensis and the agar-well diffusion method was used to assess the antifungal activity of the extract. The fungicidal/fungistatic effect was evaluated by the modified Thompson assay. The results demonstrated that the aqueous extract of Ilex paraguariensis (1000 mg/ml) possesses inhibitory activity against M. furfur. This antimalassezial activity was equivalent to 2.7 microg/ml of ketoconazole. Therefore, the topical use of Ilex paraguariensis extract as alternative antifungal agent can be suggested.

Antifungal activity of the aqueous extract of Ilex paraguariensis against Malassezia furfur.

Objective:To identify the timing, pattern, and determinants of colonization of neonates by Malassezia.Design:Prospective observational study.Setting:A neonatal medical and surgical unit consisting of 10 special care, 10 high-dependency, 10 intensive care, and 10 surgical cots.Participants:All neonates (≤ 28 days of age) or infants (> 28 days of age) admitted to the unit during the 20-week period from October 1995 to March 1996.Methods:All infants or neonates were swabbed on the day of admission and every third day thereafter and risk factors were collected for every day on the unit.Results:During the study period, 245 neonates and 42 infants were sampled for their entire duration of stay on the unit. Of these, 41 infants (97.6%) were colonized with Malassezia on admission to the unit and thereafter, as assessed by subsequent samples. Within the neonate population, 78 (31.8%) became colonized, but none were colonized immediately after birth. Univariate analysis showed that many factors appeared to be significantly associated with colonization in the neonates, including use of ventilation, presence of central venous catheters, use of parenteral nutrition, and use of antibacterial or antifungal drugs. However, when the data were analyzed by multivariate logistic regression to control for confounding variables, only gestational age and length of stay on the unit were found to be significantly associated with colonization.Conclusion:Colonization of infants is not as unusual as previously thought and many infants have established a cutaneous Malassezia commensal flora by the age of 3 to 6 months. Factors that predispose to colonization in neonates may not be the same as those that predispose to infection.

Skin colonization by Malassezia in neonates and infants.

The prevalence of M. furfur, a lipodependent fungus, in the skin of 0 to 15-year-old healthy children was studied. Sterilized carpet was used to collect skin samples which were cultured in Oxgall medium (Difco) with 1% olive oil and incubated for 10 days at 37 °C. M. furfur was recovered in 17.8% of infants, with similar findings in both sexes. The highest prevalence of M. furfur colonization was found among children of 0 to 18 months and 11 to 15-year-olds, with 23.3% and 26.7% respectively.

Cintia Di Tilia

Papers

Skin colonization by Malassezia furfur in healthy children up to 15 years old.