Skip to main content

Advertisement

SpringerLink
Log in

Association of Malassezia to Atopic Dermatitis

  • Fungal Infections of Skin and Subcutaneous (A Bonifaz, Section Editor)
  • Published:
Current Fungal Infection Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Atopic dermatitis (AD) is a common chronic, inherited, relapsing, inflammatory skin condition. A multifactorial etiology has been postulated, including genetic and immunological factors, impaired skin barrier function and environmental triggers, all of them are relevant in the pathogenesis. Malassezia spp. is the most common fungi of the skin microbiome. Most of the studies comparing the skin colonization with Malassezia spp. in healthy people and AD patients did not show difference between both groups. This review aims to show the studies carried out in this regard and the reported evidence about the role of Malassezia spp. in the pathogenesis of AD.

Recent Findings

The rate of IgE-mediated sensitization Malassezia spp. is very high in AD patients, mainly in adult patients and in patients with involvement in the head and neck. Different mechanisms have been postulated to explain the interaction of Malassezia spp. with human skin cells and immune cells and how its interaction contributes to the inflammation process in AD. Systemic and topical azole antifungals have been used with doubtful results showing beneficial effects in some AD patients.

Summary

There is no clear explanation for the high frequency of Malassezia spp. sensitization in AD patients in relation with healthy individuals. Further research is necessary to determine the specific role of Malassezia in AD and the indication for the use of antifungals in this disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Krafchik BR, Jacob S, Bieber T, et al. Eczematous dermatitis. In: Schachner L, Hansen R, editors. Pediatric dermatol. USA: Mosby; 2011. p. 851–78.

    Google Scholar 

  2. •• Glatz M, Bosshard P, Schmid-Grendelmeier P. The role of fungi in atopic dermatitis. Immunol Allergy Clin N Am. 2017;37:63–74. In a comprehensive way, this article discusses the relationship of Malassezia and atopic dermatitis.

    Article  Google Scholar 

  3. • Aspres N, Anderson C. Malassezia yeast in the pathogenesis of atopic dermatitis. Australas J Dermatol. 2004;45:199–207. Update of the role of Malassezia in atopic dermatitis.

    Article  Google Scholar 

  4. • Glatz M, Bosshard P, Hoetzenecker W, Schmid-Grendelmeier P. The role of Malassezia spp. in atopic dermatitis. J Clin Med. 2015;4:1217–28. A review of the role of Malassezia in atopic dermatitis.

  5. Weidinger S, Irvine AD. Genetics of atopic dermatitis. In: Irvine A, Hoeer P, Yan A, editors. Harper’s textbook of pediatric dermatology, 2nd volume, vol. 23. 3rd. ed. USA: Wiley; 2011. p. 1.

  6. Al-Shobalili HA, Ahmed AA, Alnomair N, et al. Molecular genetic of atopic dermatitis: an update. Int J Health Sci (Qassim). 2016;10:96–120.

    Google Scholar 

  7. •• Sullivan M, Silverberg N. Current and emerging concepts in atopic dermatitis pathogenesis. Clin Dermatol. 2017; 35:349–353. Updated contribution of the different concepts involved in the pathogenesis of atopic dermatitis.

  8. De Benedetto A, Kubo A, Beck LA. Skin barrier disruption: a requirement for allergen sensitization? J Invest Dermatol. 2012;132:949–63.

    Article  Google Scholar 

  9. Grice EA, Segre JA. The skin microbiome. Nat Rev Microbiol. 2011;9:244–53.

    Article  CAS  Google Scholar 

  10. Gailanis G, Magialis P, Hantschke M, et al. The Malassezia genus in skin and systematic diseases. Clin Microbiol Rev. 2012;25:106–41.

    Article  Google Scholar 

  11. Jagielski T, Rup E, Ziólkowska A, et al. Distribution of Malassezia species on the skin of patients with atopic dermatitis, psoriasis and healthy volunteers assessed by conventional and molecular identification methods. BMC Dermatol. 2014;14:3 http://www.biomedcentral.com/1471-5945/13/3.

    Article  Google Scholar 

  12. Prohic A, Simic D, Sadikovic TJ, Krupalija-Fazlic M. Distribution of Malassezia species on healthy human skin in Bosnia and Herzegovina: correlation with body part, age and gender. Iran J Microbiol. 2014;6(4):253–62.

    PubMed  PubMed Central  Google Scholar 

  13. Scheynius A, Johansson C, Buentke E, Zargari A, Linder MT. Atopic eczema/dermatitis syndrome and Malassezia. Int Arch Allergy Immunol. 2002;127:161–9.

    Article  CAS  Google Scholar 

  14. • Haan SH, Cheon HI, Hur MS, Kim MJ, et al. Analysis of the skin mycobiome in adult patients with atopic dermatitis. Exp Dermatol. 2018;27:366–73. Participation of Malassezia yeasts in the skin microbiota.

    Article  Google Scholar 

  15. •• Jain C, Das S, Ramachandran VG, et al. Malassezia yeast and cytokine gene polymorphism in atopic dermatitis. J Clin Diagn Res. 2017;11(3):DC01–5. Demonstration that the cytokine gene polymorphism in the susceptibility of host to Malassezia infection.

    CAS  PubMed  PubMed Central  Google Scholar 

  16. • Saunders CW, Scheynious A, Heitman J. Malassezia fungi are specialized to live on skin and associated with dandruff, eczema and other skin diseases. PLoS Pathog. 2012 Jun; 8 (6): e1002701. Participation of Malassezia yeasts in the skin microbiota.

  17. Lange L, Alter N, Keller T, Rietschel E. Sensitization to Malassezia in infants and children with atopic dermatitis: prevalence and clinical characteristics. Allergy. 2008;63:486–7.

    Article  CAS  Google Scholar 

  18. Kekki OM, Scheynius A, Poikonen S, Koskinen A, Kautiainen H, Turjanmaa K. Sensitization to Malassezia in children with atopic dermatitis combined with food allergy. Pediatr Allergy Immunol. 2013;24:244–9.

    Article  Google Scholar 

  19. Zhang E, Tanaka T, Tajima M, et al. Anti-Malassezia-secific IgE antibodies production in Japanese patients with head and neck atopic dermatitis: relationship between the level of specific IgE antibody and the colonization frequency of cutaneous Malassezia spp. and clinical severity. J Allergy (Cairo). 2011:645670. https://doi.org/10.1155/2011/645670.

  20. •• Glatz M, von Bartenwerffer W, Schmid-Grendelmeier P, et al. Malassezia spp.-specific immunoglobulin E level is a marker for severity of atopic dermatitis in adults. Acta Derm Venereol. 2015;95:191–6. Evidence of the immunological activation of Malassezia in atopic dermatitis.

    Article  Google Scholar 

  21. Selander C, Zargari A, Mollby R, Rasool O, Scheynius A. Higher pH level, corresponding to that on the skin of patients with atopic eczema, stimulates the release of Malassezia sympodialis allergens. Allergy. 2006;61:1002–8.

    Article  CAS  Google Scholar 

  22. Balaji H, Heratizadeh A, Wichmann K, Niebuhr M, Crameri R, Scheynius A, et al. Malassezia sympodialis thioredoxin-specific T cells are highly cross-reactive to human thoredoxin in atopic dermatitis. J Allergy Clin Immunol. 2011;128:92–9 e4.

  23. Schmid-Grendelmeier P, Fluckger S, Disch R, et al. IgE-mediated and T cell-mediated autoimmunity against manganese superoxide dismutase in atopic dermatitis. J Allergy Clin Immunol. 2005;115:1068–75.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Dermatology, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Del. Cuauhtemoc, 06720, Ciudad de México, CP, Mexico

    Adriana Valencia-Herrera, Mirna Toledo-Bahena, Carlos Mena-Cedillos & Jade Castellanos

  2. Star Médica Hospital Infantil Privado, Mexico City, Mexico

    Erika Ramírez-Cortés

  3. Department of Dermatology, Allergy and Immunology, Hospital del Niño y del Adolescente Morelense, Mexico City, Mexico

    Mario Duarte-Abdala

  4. Dermatology Division, Hospital General Dr. Manuel Gea González, Mexico City, Mexico

    Sonia Toussaint-Caire

  5. Dermatology & Mycology Service, Hospital General de México. Dr. Eduardo Liceaga, Mexico City, Mexico

    Alexandro Bonifaz

Authors
  1. Adriana Valencia-Herrera
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mirna Toledo-Bahena
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Erika Ramírez-Cortés
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mario Duarte-Abdala
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sonia Toussaint-Caire
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Carlos Mena-Cedillos
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jade Castellanos
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Alexandro Bonifaz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mirna Toledo-Bahena.

Ethics declarations

Conflict of Interest

The authors declare that they have no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Fungal Infections of Skin and Subcutaneous Tissue

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Valencia-Herrera, A., Toledo-Bahena, M., Ramírez-Cortés, E. et al. Association of Malassezia to Atopic Dermatitis. Curr Fungal Infect Rep 12, 201–206 (2018). https://doi.org/10.1007/s12281-018-0330-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12281-018-0330-0

Keywords

Search

Navigation