Dermoscopy as an Auxiliary Tool in the Assessment of Malassezia Folliculitis: An Observational Study

Abstract

Malassezia folliculitis is an under-recognized entity commonly affecting the face and upper trunk. Clinical picture mimics acne vulgaris and diagnosis is challenging at times. Ten percent potassium hydroxide examination is usually performed to confirm the diagnosis. This study sought to describe the dermoscopic features in Malassezia folliculitis. Patients diagnosed clinically with Malassezia folliculitis and confirmed by 10% potassium hydroxide preparation were included in the study. Dermoscopy was performed with a videodermatoscope (Dino-Lite AM413ZT; Polarizer) from the most representative lesion. A total of 45 patients (M:F=1:0.8) were recruited. All patients had monomorphic papulo-pustular lesions. Itching was present in 64.4% patients. Dermoscopy reveled folliculocentricity (100%), perilesional background erythema (100%), dotted/linear/tortous vessels (88.9%), dirty white scaling (77.8%), hypopigmentation of hair follicle (64.4%), coiled/looped hairs (57.8%) and broken hairs (13.3%). In conclusion, dermoscopy shows typical features in Malassezia folliculitis and can serve as a office-based tool for identification of this entity.

Keywords: Acne vulgaris; Acné vulgar; Dermatoscopia; Dermoscopy; Foliculitis por Malassezia; Foliculitis por Pityrosporum; Malassezia; Malassezia folliculitis; Pityrosporum folliculitis.