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BMC Dermatology
Published in: BMC Dermatology 1/2020

01-12-2020 | Fluconazole | Case report

A case of anti- pityriasis versicolor therapy that preserves healthy mycobiome

Authors: Mariusz Dyląg, Ewa Leniak, Sebastian Gnat, Jacek C. Szepietowski, Lukasz Kozubowski

Published in: BMC Dermatology | Issue 1/2020

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Abstract

Background

The impact of Malassezia yeasts on skin mycobiome and health has received considerable attention recently. Pityriasis versicolor (PV), a common dermatosis caused by Malassezia genus worldwide, is a manifestation of dysbiosis. PV can be associated with hyper- and/or hypopigmented skin lesions. This disease entity is characterized by high percentage of relapses, which demands a proper antifungal therapy that is based on unambiguous species identification and drug susceptibility testing.

Case presentation

Comprehensive analysis of PV case in man presenting simultaneously hyper- and hypopigmented skin lesions was performed. Conventional and molecular diagnostic procedures revealed Malassezia furfur and Malassezia sympodialis, respectively as etiological agents of skin lesions observed. Susceptibility tests showed significantly lowered sensitivity of M. furfur cells to fluconazole. Based on susceptibility profiles local antifungal therapy with drugs characterized by entirely different mechanism of action was included.

Conclusions

Our study indicates that cases of PV represented by two types of skin lesions in one patient may be associated with distinct Malassezia species. Moreover, as observed in this case, each of the isolated etiological agents of PV may differ significantly in susceptibility to antifungals. This can significantly complicate the treatment of dermatosis, which by definition is associated with a significant percentage of relapses. In the presented case localized topical treatment was sufficient and successful while allowing maintaining the physiological mycobiome.
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Metadata
Title
A case of anti- pityriasis versicolor therapy that preserves healthy mycobiome
Authors
Mariusz Dyląg
Ewa Leniak
Sebastian Gnat
Jacek C. Szepietowski
Lukasz Kozubowski
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Dermatology / Issue 1/2020
Electronic ISSN: 1471-5945
DOI
https://doi.org/10.1186/s12895-020-00106-x

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