Coexistence of Malassezia Species and Microsporum canis in the Lesions of Adult with Tinea Capitis

Summary

A 60-year-old woman developed unusual hair loss and rash on her scalp that looked like dandruff. Tests revealed three types of fungi, including Microsporum canis (usually found in animals) and two types of Malassezia yeast. Treatment with antifungal medications for three months cleared the infection. Laboratory experiments showed that the yeast species may actually help the fungus grow better, which could explain why adults sometimes get scalp fungal infections differently than children.

Background

Tinea capitis is a superficial fungal infection primarily affecting the scalp and hair, more common in children but increasingly observed in adults. Adult tinea capitis often presents with atypical manifestations resembling seborrheic dermatitis. The condition is typically caused by dermatophytes such as Trichophyton and Microsporum species.

Objective

To report and investigate a unique case of adult tinea capitis presenting with coinfection of Malassezia species and Microsporum canis. The study aimed to examine the interaction between these fungal species through in vitro co-culture experiments to understand their role in adult tinea capitis development.

Results

Three fungal species were identified: Microsporum canis, Malassezia globosa, and Malassezia furfur. Co-culture experiments revealed that Malassezia appeared to facilitate Microsporum canis growth on mDixon medium, particularly at higher temperatures. The patient achieved clinical resolution with 3 months of oral antifungal therapy and maintained remission at 6-month follow-up.

Conclusion

Malassezia species may promote the growth of Microsporum canis through consumption of long-chain fatty acids, potentially contributing to adult tinea capitis development. This study suggests that tinea capitis may involve multiple fungal species rather than single pathogen infections, requiring consideration of complex fungal interactions in diagnosis and treatment.
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