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[Clinical problems in medical mycology: problem number 53]
Fernando Messina1, María Romero1, Emmanuel Marin1
1Unidad de Micología, Hospital de Infecciosas Francisco Javier Muñiz, Buenos Aires, Argentina.
Revista Iberoamericana De Micologia
|March 14, 2019
Summary
This study reports a rare case of a 21-year-old HIV-positive man with poor treatment adherence who presented with both a papular rash and hypochromic stains. Both conditions were successfully treated with oral itraconazole, caused by Malassezia yeast.
Area of Science:
- Dermatology
- Infectious Diseases
- Mycology
Background:
- Human Immunodeficiency Virus (HIV) infection can predispose individuals to various opportunistic infections.
- Antiretroviral therapy (ART) adherence is crucial for managing HIV and preventing opportunistic conditions.
- Cutaneous manifestations in HIV-infected individuals are diverse and can be challenging to diagnose.
Observation:
- A 21-year-old male with HIV and suboptimal ART adherence presented with a papular rash on his trunk and extremities.
- Simultaneously, the patient exhibited hypochromic macules on his back.
- Mycological examination of skin lesions revealed yeasts consistent with Malassezia species.
Findings:
- Malassezia yeast was identified as the causative agent for both the papular rash and the hypochromic stains in the same patient.
- This dual presentation of distinct clinical pictures by the same etiological agent in a single patient is exceptionally uncommon.
- Treatment with oral itraconazole resulted in a complete clinical resolution of both dermatological conditions.
Implications:
- This case highlights the potential for Malassezia to cause varied cutaneous presentations in immunocompromised individuals.
- It underscores the importance of thorough mycological investigation in HIV patients with unusual skin findings.
- Successful treatment with itraconazole suggests its efficacy in managing complex Malassezia-related dermatoses in this population.
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