Malassezia (Pityrosporum)
folliculitis usually appears as pruritic monomorphous papules and pustules on the upper back, chest, extensor arms and face.
Acne vulgaris, bacterial
folliculitis, eosinophilic
folliculitis and systemic
corticosteroid-induced
acne can clinically mimic the fungal-caused acneiform condition. The designation incognito is used to describe
tinea or
scabies when the characteristic presentation is masqueraded by the application of topical
corticosteroid treatment. Application of
corticosteroid cream altered the morphology of the skin lesions in a man with Malassezia
folliculitis. His cutaneous findings-localized areas of post-inflammatory
hyperpigmentation with flattened or completely resolved follicular papules-raised the possibility of partially treated follicular
eczema or follicular
contact dermatitis. Pathognomonic findings from biopsies of the skin lesions established the diagnosis of Malassezia
folliculitis; the condition completely resolved
after treatment with topical antifungal shampoo and cream. Similar to
tinea incognito and
scabies incognito,
folliculitis caused by Malassezia yeast in which the cutaneous morphology has been concealed by management with topical
corticosteroids should be referred to as Malassezia (Pityrosporum)
folliculitis incognito.