Clinical features and treatment of Malassezia folliculitis with fluconazole in orthotopic heart transplant recipients

J Heart Lung Transplant. 2000 Feb;19(2):215-9. doi: 10.1016/s1053-2498(99)00123-0.


Orthotopic heart transplant recipients need immunosuppressive treatment and are at an increased risk for opportunistic infections such as Malassezia folliculitis. During a 4-month period (July to October 1990), 11 such cases were identified and treated; all were male with mean age of 43+/-9 years and on standard triple immunosuppressive therapy. Skin scrapings in potassium hydroxide (KOH) preparation with microscopy and/or culture identified either Malassezia furfur or Malassezia pachydermatis as the etiologic agent. A treatment with topical preparation (clotrimazole 1% and selenium sulfide lotion) was effective in 6 patients, whereas the rest received systemic fluconazole treatment with satisfactory outcome; all lesions were resolved within 3 weeks. Fluconazole appears to be an effective agent with excellent therapeutic outcome when administered for 3 weeks.

MeSH terms

  • Adult
  • Antifungal Agents / therapeutic use*
  • Dermatomycoses / diagnosis
  • Dermatomycoses / drug therapy*
  • Dermatomycoses / pathology
  • Female
  • Fluconazole / therapeutic use*
  • Folliculitis / drug therapy*
  • Folliculitis / microbiology*
  • Heart Transplantation* / immunology
  • Humans
  • Immunocompromised Host*
  • Malassezia*
  • Male
  • Middle Aged


  • Antifungal Agents
  • Fluconazole