What is Malassezia contagiosa (a fungal infection)?

From the Guidelines

Malassezia contahiois is not a recognized species, and treatment should focus on managing Malassezia-related skin conditions such as seborrheic dermatitis, which can be effectively treated with topical antifungal medications. According to the clinical practice guideline for acute otitis externa 1, seborrheic dermatitis is a common condition affecting the ears, scalp, central face, and other sebaceous areas of the skin, and is characterized by greasy yellowish scaling, itching, and secondary inflammation from Malassezia yeast. Key points to consider in managing Malassezia-related skin conditions include:

• Reducing the amount of yeast present with topical antifungal medications
• Reducing inflammation and itch with topical anti-inflammatory medications
• Maintaining good hygiene and keeping the skin dry to prevent recurrence
• Avoiding irritants and allergens that can exacerbate the condition, such as certain metals, chemicals, or otic preparations 1. The use of topical corticosteroids and other antipruritics may also be necessary to manage symptoms and prevent secondary skin infections 1.

From the FDA Drug Label

Ketoconazole Cream 2% is indicated for the topical treatment of ... tinea (pityriasis) versicolor caused by Malassezia furfur (Pityrosporum orbiculare); Microbiology: ... yeasts: ... Malassezia ovale (Pityrosporum ovale) and ... Malassezia furfur (Pityrosporum orbiculare). Ketoconazole is used to treat tinea versicolor caused by Malassezia furfur.

• The drug label 2 and 2 support the use of ketoconazole for Malassezia infections, specifically Malassezia furfur.
• Malassezia contahiois is not explicitly mentioned in the label, but Malassezia furfur is, which suggests that ketoconazole may be effective against Malassezia species. However, without direct information on Malassezia contahiois, no conclusion can be drawn.

From the Research

Malassezia Infection

• Malassezia is a yeast that naturally colonizes on the skin's surface and can cause pityriasis versicolor, a common superficial fungal infection 3.
• The infection is characterized by scaly hypopigmented or hyperpigmented patches, primarily affecting the upper trunk, neck, and upper arms 3.
• Malassezia can directly harm the host via virulence factors or toxins, or indirectly by triggering damaging host responses 3.

Diagnosis and Treatment

• The diagnosis of pityriasis versicolor typically relies on recognizing characteristic clinical features, and differential diagnosis is critical due to the wide variability in its clinical presentation 3.
• Topical therapies are the primary treatment for pityriasis versicolor, including non-specific antifungal agents and specific topical antifungal medications 3, 4.
• Systemic therapies, such as ketoconazole and fluconazole, may also be used to treat extensive cases of pityriasis versicolor 5, 6, 7.
• The efficacy of ketoconazole and fluconazole in treating pityriasis versicolor has been compared in several studies, with fluconazole showing a higher clinical and mycological cure rate in some cases 6, 7.

Treatment Options

• Topical ketoconazole has been shown to be effective in treating Malassezia-related conditions, including seborrheic dermatitis and pityriasis versicolor, with a reported efficacy of 63-90% and 71-89%, respectively 4.
• Fluconazole has also been shown to be effective in treating pityriasis versicolor, with a single dose of 400 mg providing the best clinical and mycological cure rate with no relapse during twelve months of follow-up 6.
• The choice of treatment depends on the severity and extent of the infection, as well as the patient's medical history and potential side effects of the treatment 3, 5, 7.