Position statement: Recommendations on the diagnosis and treatment of Malassezia folliculitis

Malassezia is a lipophilic yeast that is a part of the human mycobiome. Malassezia folliculitis appears when the benign colonization of the hair follicles, by the Malassezia yeasts, becomes symptomatic with pruritic papules and pustules. Although Malassezia folliculitis is common in hospital departments, diagnosing and treating it varies among dermatologists and countries. The European Academy of Dermatology and Venereology Mycology Task Force Malassezia folliculitis working group has, therefore, sought to develop these recommendations for the diagnosis and management of Malassezia folliculitis. Recommendations comprise methods for diagnosing Malassezia folliculitis, required positive findings before starting therapies and specific treatment algorithms for individuals who are immunocompetent, immunocompromised or who have compromised liver function. In conclusion, this study provides a clinical strategy for diagnosing and managing Malassezia folliculitis.

Automated summary

Malassezia folliculitis occurs when the benign colonization of hair follicles by the yeast Malassezia becomes symptomatic, leading to itchy papules and pustules. However, diagnosing and treating this condition varies among dermatologists and countries. The European Academy of Dermatology and Venereology Mycology Task Force has developed recommendations to guide the diagnosis and management of Malassezia folliculitis, including diagnostic methods, required positive findings before treatment, and specific treatment algorithms for different patient groups. Overall, this study provides a clinical strategy for diagnosing and managing Malassezia folliculitis.