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Skin Colonization by Malassezia Species in Neonates
A Prospective Study and Relationship With Neonatal Cephalic Pustulosis
Vincent Bernier, MD;
François X. Weill, MD;
Virginie Hirigoyen, MD;
Christophe Elleau, MD;
Anne Feyler, MD;
Christine Labrèze, MD;
Jean Sarlangue, MD;
Geneviève Chène, MD;
Bernard Couprie, MD;
Alain Taïeb, MD
Arch Dermatol. 2002;138:215-218.
Objectives To assess skin colonization by Malassezia species
in full-term healthy newborns, to investigate factors associated with colonization,
and to look at acnelike cephalic pustulosis associated with this carriage.
Design Samples were obtained from neonates and their mothers 0 to 5 days after
birth and again 3 weeks later. Clinical patterns of common acnelike pustulosis
were reported as mild (<10 papulopustules), moderate ( 10 papulopustules),
or absent. Direct examination and culture of sample. Identification of yeasts
was based on microscopic and physiologic criteria.
Setting A maternity hospital and the pediatric dermatology unit of a university
hospital.
Participants Consecutive series of 102 neonates and their mothers.
Main Outcome Measures Incidence of skin colonization and type of Malassezia species found in neonates and correlation with neonatal cephalic pustulosis
(neonatal acne).
Results At the first visit, 11 neonates and 36 mothers had cultures positive
for Malassezia. Malassezia sympodialis and Malassezia globosa were preferentially
cultured. At 3 weeks, 29 (52%) of 56 neonates and 18 (32%) of 56 mothers had
cultures positive for only M sympodialis and M globosa. Breastfeeding was not associated with a higher
prevalence of Malassezia carriage in neonates. Malassezia colonization was higher when pustulosis was
more severe and M sympodialis was found in pustules.
Conclusions Malassezia colonization begins at birth and
increases in the first weeks of life. A high prevalence of M sympodialis in neonates is noted from birth. Its association with
neonatal acne is confirmed. Further investigation is needed to study the role
of sebum secretion rate and quality in the neonatal period.
From the Pediatric Dermatology Unit (Drs Bernier, Labrèze, and
Taïeb), the Laboratory of Mycology (Drs Weill, Hirigoyen, Chène,
and Couprie), and the Departments of Neonatal Medicine (Drs Elleau and Sarlangue)
and Medical Information (Drs Feyler and Chène), Centre Hospitalier
et Universitaire de Bordeaux, Bordeaux, France.
RELATED ARTICLES
Neonatal Acne and Cephalic Pustulosis: Is Malassezia the Whole Story?
James N. Bergman and Lawrence F. Eichenfield
Arch Dermatol. 2002;138(2):255-257.
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Archives of Dermatology Reader's Choice: Continuing Medical Education
Arch Dermatol. 2002;138(2):283-284.
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Neonatal Acne and Cephalic Pustulosis: Is Malassezia the Whole Story?
Bergman and Eichenfield
Arch Dermatol 2002;138:255-257.
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