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Abstract：
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.
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.
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.
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.
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.
摘要：
近年来，马拉色菌对皮肤真菌和健康的影响受到了广泛的关注。花色糠疹（PV），一种由全球马拉色菌属引起的常见皮肤病，是生态失调的表现。PV可与高色素和/或低色素皮肤损伤相关。这种疾病实体的特点是复发比例很高，这需要基于明确的物种鉴定和药物敏感性测试的适当抗真菌治疗。
对同时表现为高色素和低色素皮肤病变的男性PV病例进行了综合分析。常规和分子诊断程序显示了糠马拉色菌和马拉色菌，分别作为皮肤病变的病因观察。药敏试验表明，糠M.furfer细胞对氟康唑的敏感性显着降低。根据药敏情况，包括使用具有完全不同作用机制的药物进行局部抗真菌治疗。
我们的研究表明，一名患者中由两种类型的皮肤病变代表的PV病例可能与不同的马拉色菌种类有关。此外，正如在这种情况下观察到的，每种分离的PV病原体对抗真菌药物的敏感性可能存在显着差异。这会使皮肤病的治疗复杂化，根据定义，这与相当比例的复发有关。在所提供的情况下，局部局部治疗是足够且成功的，同时允许维持生理分枝杆菌。
对同时表现为高色素和低色素皮肤病变的男性PV病例进行了综合分析。常规和分子诊断程序显示了糠马拉色菌和马拉色菌，分别作为皮肤病变的病因观察。药敏试验表明，糠M.furfer细胞对氟康唑的敏感性显着降低。根据药敏情况，包括使用具有完全不同作用机制的药物进行局部抗真菌治疗。
我们的研究表明，一名患者中由两种类型的皮肤病变代表的PV病例可能与不同的马拉色菌种类有关。此外，正如在这种情况下观察到的，每种分离的PV病原体对抗真菌药物的敏感性可能存在显着差异。这会使皮肤病的治疗复杂化，根据定义，这与相当比例的复发有关。在所提供的情况下，局部局部治疗是足够且成功的，同时允许维持生理分枝杆菌。
