malassezia taxonomy kingdom: fungi basidiomycota ...crcooper01.people.ysu.edu/malassezia-x11.pdf ·...
TRANSCRIPT
7/14/11
1
Malassezia Infections
Presentation Developed By: Courtney Madden, Megan Lileas & Nita Gupta
Malassezia Infections
Alternate Names: Pityrosporum
Obsolete name for this genus
Yeast Infections
(Images courtesy of http://www.buyaldaracream.com/buy-diflucan.htm and http://208.88.129.137/product/catalog/product_detail.aspx?id=36&prodid=154&seachproducts=K)
Malassezia Taxonomy
Kingdom: Fungi Phylum: Basidiomycota Class: Hymenomycetes Order: Tremellales Family: Filobasidiaceae Genus: Malassezia
Malassezia Infections Etiologic Agent and Taxonomy
(11 species): Malassezia furfur-most
common Malassezia globosa Malassezia obtusa-rarely
recovered Malassezia restricta Malassezia sloofiae Malassezia sympodialis Malassezia pachydermatis Malassezia dermatis Malassezia japonica Malassezia nana Malassezia yamatoensis
Malassezia A colononizing yeast found
on dermis and other body surfaces of humans and animals
Most species require long fatty-acid chains to grow well (lipophilic)-except M. pachydermatis
Normal skin flora- colonies found on up to 90% of adults (www.doctorfungus.com)
Cells are globular to ellipsoidal in shape
Conidia (asexual spore off hyphae branch) is primary form
Malassezia Geographical Distribution (Image courtesy of www.dsc.dicovery.com)
More common in adults More common in tropical
areas with up to a 40-60% infection rate (Clinical Mycology)
Japan- M. sympodialis, M. furfur
Spain- M. sympodialis, M. globosa
M. globosa- commonly seen in the scalps of UK residents
M. furfur- tropical areas
7/14/11
2
Malassezia Life Cycle No telomere phase Yeast cells and hyphae Found as colony on skin in
budding forms Raised and smooth in
cultures Get dry and wrinkled as
they age During an infection change
to mycelial form In temperate regions
clusters of hyphae suggesting form differs depending of location
Malassezia Life Cycle (Image courtesy of http://www.mycology.adelaide.edu.au/
Mycoses/Superficial/Malassezia_infections/) Asexually reproduction only Collarettes Usually single buds
Mature in about 5 days in 30-37 degree climate
Vary in color from creamy yellow to brown or orange-beige
Epidemiology Patients who are affected
by immuno-suppressant conditions such as AIDS are at a higher risk of contracting an infection
Adults carry more Malassezia than children
An increase in Malassezia is found on teenagers because the increased activity in sebaceous glands provides nutrition for the lipophilic yeast
(images courtesy of http://dailynewsstore.blogspot.com/2009/11/aids-pictures.html & http://www.medindia.net/beauty/facepimples.asp)
Epidemiology (Images courtesy of http://www.kaboodle.com & http://
getpregnant2day.com/getting-pregnant/) People receiving antibiotics or steroid treatment are more susceptible
Higher risk in pregnant women and diabetics
Common in tropics Relapses may occur with
anti-dandruff or anti-fungal drugs
Neonatals who are on parenteral nourishment with lipids
Pathogenesis: Pityriasis versicolor Occurs in healthy and
immune compromised people Very common fungal
disease that stays a very long time on skin
M. globosa & M. sympodialis Budding yeasts Occurs in hot, humid
climates
Skin rash on the trunk that is usually discolored, slightly reddish brown
Treatment with dandruff medications or anti-fungals
(Image courtesy of http://www.patient.co.uk/doctor/ Pityriasis-Versicolor.htm)
Pathogenesis: Pityriasis Versicolor Occurs in healthy and immuno-compromised patients
Also known as Tinea Versicolor Caused by the excessive growth of Pityrosporum orbiculare
(Malassezia furfur). Also caused by M. globosa and M. sympodialis
Profuse perspiration and an abundance of oil produced in skin allows fungi to grow
Appear as discolored flaky patches on the skin The color of the patches will change with sun exposure Treatment with dandruff medications or anti-fungals Commonly affected areas: chest, back, upper arm, neck Skin pigmentation changes may last after fungus is treated
7/14/11
3
Pathogenesis: Pityriases Folliculitis Localized papules, pimple,
and pustules often show up after sun exposure
Hair follicles become infected and inflammed by the fungi Pityrosporum orbiculare (more severe condition of pityriasis versicolor)
Common in hot, humid tropical climates where UV rays are stronger
Heat & friction irritates follicles
Often chronic and undiagnosed for years
Occurs mostly in immuno-compromised patients and diabetics
Mild cases treated with imidazole
More severe cases-ketoconazole or itraconazole (all are anti-fungals) (Image courtesy of http://www.mycology.adelaide.edu.au/Mycoses/Superficial/Malassezia_infections/)
Pathogenesis: Seborrheic Dermatitis More commonly known as
dandruff M. Yamatoensis Inflammatory skin conditions Known as cradle cap when
appears in infants White-yellowish scales appear on
or near oily areas of skin This condition can run in families
and appear more commonly in patients with neurological conditions and immune compromised
Chronic (life-long) condition May affect scalp and inner ear Not due to poor hygiene Scale color varies depending on environmental conditions (Image courtesy of http://www.dermatitisseborrheic.net/ & http://emedicbuzz.com/tag/seborrheic-dermatitis/)
Pathogenesis: Catheter-Related Fungemia in Neonates (image courtesy of http://infections.consultantlive.com/
display/article/1145625/1394106) Opportunistic systematic infection
Infection in newborns Presence of venous
catheters Prolonged
hospitalization Most common in
patients receiving lipid replacement therapy (helps increase weight)
Pathogenesis: Atopic Dermatitis M. globosa and M. restricta
cause the condition Stays inflammed for a long
period of time May be blisters or red
irritated skin that crusts over Sometimes ear discharge or
bleeding may occur According to the American
Society for Microbiology, patients with atopic dermatitis produce Malassezia specific immunoglobulin E (IgE) whereas healthy patients do not
Furthermore anti-fungals can improve symptoms of atopic dermatitis
(images courtesy of http://prescriptionworld.org/ and http://www.cssd.us/body.cfm?id=499)
Pathogenesis
Acne Vulgaris Dacrocystitis More commonly known as
acne Whiteheads, blackheads,
pimples, pustules When follicles in skin
become clogged Swelling and inflammation
Inflammation of the lacrimal sac in the inner ear
Redness and discharge (Images courtesy http://www.eyesurgeononline.com/
services.html & http://www.getacnehomeremedies.info)
Pathogenesis
Seborrheic Blepharitis Psoriasis
Chronic inflammation of the eyelid
Burning, sensitivity, irritation, blurred vision
(image from http://www.e-psoriasis.com/app/diagnosis.asp)
Age 15-35 Skin infection and
irritation Have red skin with yellow
flaky scales Severe in people with
weak immune system Some types genetic, some
caused from fungus
7/14/11
4
Pathogenesis
Onchyomycosis Confluent & Reticulated Papillomatosis
Nail infection Athlete's foot, jock itch,
ringworm Need heat and humidity (image from http://www.myfootshop.com)
Skin infection on the trunk or chest
Forms brown scaly papules over skin
(images from http://www.dermis.net)
Case Study Clinical Aspects of Patients
with Pityriasis Versicolor at a Tropical Center for Dermatology Malassezia spp. Originally
found M. furfur to be the only causative agent, now 13 species in Malassezia genus.
Study used 116 subjects: varying in age, race, gender, skin type, occupation, and clinical features of disease
Subjects were not allowed to use any type of medication within 30 days of study.
All had a positive direct mycological examination and filled out questionaire to aid in why and how people become infected
Image from: health.allrefer.com
Case Study: Findings and Factors Most commonly affected ages: 10-20 (33.6%=39/116)
Resulting from greater development of sebaceous gland, which produce more sebum (oil)
Found higher frequency in males in this study (others have showed no predominance in genders)
Race and occupation had little to no relevance Factors involved: genetic inheritance, elevated
temperatures, humidity, use of oils/moisturizers, immunosuppression, malnutrition, and chemical composition of sebum.
Case Study: Involvement Most common areas
affected are: Trunk and upper limbs
Degree of involvement was more commonly extensive (4 or more regions)
Table from Anais Brasileiros de Dermatologiaversion ISSN 0365-0596
Case Study: Treatment
Most commonly and effective were combination of topical and oral medications Including keratolytic
and azolic antifungal agents
Recurrence are frequent
Can become chronic without treatment Image from members.kaiserpermanente.org
References Aly, R. et al. "Malassezia spp.." DoctorFungus.
N.p., n.d. Web. 08 Jul 2011. <http://www.doctorfungus.org/thefungi/ malassezia.php>.
Armstrong, D., F. F. Edwards, T. E. Kiehn, A. E. Brown, and G. R. Garber. "Catheter-related Malassezia Furfur Fungemia in Immunocompromised Patients." The American Journal of Medicine 95.4 (1993): 365-70. PubMed.gov. Web. 12 July 2011.
Berman, Kevin. "Psoriasis - PubMed Health." National Center for Biotechnology Information. 8 Nov. 2010. Web. 13 July 2011. <http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001470/>.
Berman, Kevin. "Seborrheic Dermatitis - PubMed Health." National Center for Biotechnology Information. Web. 13 July 2011. <http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001959/>.
"Blepharitis-PubMed Health." National Center for Biotechnology Information. May 2010. Web. 13 July 2011. <http://www.ncbi.nlm.nih.gov/ pubmed/20590417>.
Cohen, Bernard A. "DermAtlas: Online Dermatology Image Library." Dermatlas: Dermatology Image Atlas with 12474 Dermatology Images. 3 Apr. 2011. Web. 13 July 2011. <http://dermatlas.med.jhmi.edu/derm/result.cfm?Diagnosis=2073016827>.
Ellis, David "Malassezia Infections." The University of Adelaide. N.p., 2011. Web. 08 Jul 2011. <http://www.mycology.adelaide.edu.au/Mycoses/Superficial/Malassezia_infections/>.
"Malassezia Fungemia in Neonates and Adults: Complication of Hyperalimentation." Web. 13 July 2011. <http://www.ncbi.nlm.nih.gov/pubmed/3125578>.
Morias, Patrícia Motta de; CUNHA, Maria da Graça Souza and FROTA, Maria Zeli Moreira. Clinical aspects of patients with pityriasis versicolor seen at a referral center for tropical dermatology in Manaus, Amazonas, Brazil. An. Bras. Dermatol. [online]. 2010, vol.85, n.6 [cited 2011-07-13], pp. 797-803 . Available from: <http:www.scielo.brscielo.phpscript>
Oakley, Amanda. "Pityriasis Versicolor (tinea Versicolor, Yeast Infection). DermNet NZ." DermNet NZ. Facts about Skin from New Zealand Dermatological Society. New Zealand Dermatological Society Incorporated, 29 June 2011. Web. 12 July 2011. <http://dermnetnz.org/ fungal/pityriasis-versicolor.html>.
7/14/11
5
References "Pityriasis Versicolor." NetDoctor.co.uk -
The UK's Leading Independent Health Website. Ed. John Pillinger. 10 June 2008. Web. 11 July 2011. <http://www.netdoctor.co.uk/ diseases/facts/pityriasisversicolor.htm>.
"Seborrheic Dermatitis: MedlinePlus Medical Encyclopedia." National Library of Medicine - National Institutes of Health. Ed. Kevin Berman. Merican Accreditation HealthCare Commission, 18 July 2007. Web. 11 July 2011. <http://www.nlm.nih.gov/medlineplus/ency/article/000963.htm>.
Sugita, Takashi, Mami Tajima, Hisae Tsubuku, and Ryoji Tsuboi Akemi Nishikawa. "A New Calcineurin Inhibitor, Pimecrolimus, Inhibits the Growth of Malassezia spp. ." Antimicrobial Agents and Chemotherapy 50.8 2897-2898. Web. 11 Jul 2011. <http:// aac.asm.org/cgi/content/full/50/8/2897>.
Vordick, Linda J. "Atopic Eczema - PubMed Health." National Center for Biotechnology Information. 10 Oct. 2010. Web. 13 July 2011. <http://www.ncbi.nlm.nih.gov/ pubmedhealth/PMH0001856/>.
Vordick, Linda J. "Fungal Nail Infection - PubMed Health." National Center for Biotechnology Information. 4 Oct. 2010. Web. 13 July 2011. <http://www.ncbi.nlm.nih.gov/ pubmedhealth/PMH0002306/>.
Vorvick, Linda J. "Folliculitis - PubMed Health." National Center for Biotechnology Information. 28 Oct. 2010. Web. 13 July 2011. <http://www.ncbi.nlm.nih.gov/ pubmedhealth/PMH0001826/>.
Vorvick, Linda J. "Tinea Versicolor - PubMed Health." National Center for Biotechnology Information. 10 Oct. 2010. Web. 13 July 2011. <http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002436/>.