Most of the studies published thus far now show that Malassezia globosa is the predominant species found in the lesions of pityriasis versicolor, at least in temperate climates. The authors' recent findings confirm these results. The etiologic role of M. globosa in pityriasis versicolor is based, even more than on its isolation in a high percentage of cultures, on its identification by direct microscopy as typical globose yeast cells producing pseudohyphae in almost 100% of cases. The confirmation of the pathogenic role of this species in pityriasis versicolor could help in understanding these conditions, which are still unclear, which promote its transformation from the saprophytic stage present in healthy skin to the parasitic one, and could also help in selecting the best therapeutic measures.
In tinea of glabrous skin with low response to topical antifungal treatment we must rule out tinea of the vellus hair. Infection by nonanthropophilic dermatophytes, previous corticosteroid therapy and excoriation might be predisposing factors. Parasitism of the vellus hair, observed by direct microscopy, should be another criterion for establishing systemic treatment from the onset, as is the case in tinea capitis.
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