The Role of Malassezia Spp. in Pityrasis Versicolor: A Literature Review
Main Article Content
Abstract
Pityriasis versicolor (PV) is a skin disease caused by the fungus Malassezia, common in tropical regions with high humidity, such as Indonesia. Pityriasis versicolor is characterized by hypopigmented or hyperpigmented patches, primarily on the chest, back, neck, and face, with some cases accompanied by itching. Risk factors include oily skin, immune conditions, genetics, and hot and humid environments. Further research is needed to understand the role of Malassezia in Pityriasis versicolor to improve treatment and prevent recurrence. To determine the role of Malassezia spp. in Pityriasis versicolor (PV) based on a literature review. Literature review with a narrative review design. Based on several reviewed journals, it can be concluded that Malassezia spp., which are part of the normal skin microbiota, can become pathogenic in individuals with certain predisposing factors. The transformation from yeast to hyphae, as well as the production of virulence factors such as lipase, protease, phospholipase, azelaic acid, melanin-like pigments, and the ability to form biofilms, play a role in the development of Pityriasis versicolor lesions. Interaction with the host occurs through direct mechanisms (irritant metabolites, keratinase) and immunological mechanisms (activation of inflammatory and allergic pathways), leading to skin barrier disruption, pigmentation changes, fine scaling, and potential alopecia. Variation in species and virulence profiles contributes to differences in clinical manifestations and responses to antifungal therapy. Malassezia spp. plays a key role in the development of Pityriasis versicolor through multifactorial virulence mechanisms and interactions with host predisposing factors, which influence clinical manifestations and treatment outcomes.
Article Details
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
References
Abdi, D. A., Surdam, Z., Waspodo, N. N., & Nasaruddin, H. (2024). Pengaruh Perilaku Hygiene dengan Kejadian Pityriasis Versicolor pada Siswa. Fakumi Medical Journal: Jurnal Mahasiswa Kedokteran, 4(4), 271-277. https://doi.org/10.33096/fmj.v4i4.401
Abhinaya, R. F., Trasia, R. F., & Adawiyah, R. (2024). The Relationship between Knowledge and Personal Hygiene Behavior on the Prevalence of Pityriasis Versicolor in Construction Workers at Serang City. International Journal of Medicine and Public Health, 1(2), 31-40. https://dx.doi.org/10.62870/inomed.v1i2.25736
Abraham, C., & Medzhitov, R. (2011). Interactions between the host innate immune system and microbes in inflammatory bowel disease. Gastroenterology, 140(6), 1729-1737. https://doi.org/10.1053/j.gastro.2011.02.012
Alfei, S., & Caviglia, D. (2022). Prevention and eradication of biofilm by dendrimers: A possibility still little explored. Pharmaceutics, 14(10), 2016. https://doi.org/10.3390/pharmaceutics14102016
Aljabre, S. H., Alzayir, A. A., Abdulghani, M., & Osman, O. O. (2001). Pigmentary changes of tinea versicolor in dark‐skinned patients. International journal of dermatology, 40(4), 273-275. https://doi.org/10.1046/j.1365-4362.2001.01201.x
Aritonang, B. N. R. S., Hutasoit, H., Yuliandari, A., Verdinasari, I., Naranz, A., & Yola, S. (2022). Identifikasi Malassezia furfur pada kerokan kulit petani sawit PT Panca Surya Garden. Prosiding Asosiasi Institusi Pendidikan Tinggi Teknologi Laboratorium Medik Indonesia, 1, 1-10.
Bay, L., Jemec, G. B., & Ring, H. C. (2024). Microenvironmental host–microbe interactions in chronic inflammatory skin diseases. Apmis, 132(12), 974-984. https://doi.org/10.1111/apm.13464
Billamboz, M., & Jawhara, S. (2023). Anti-malassezia drug candidates based on virulence factors of malassezia-associated diseases. Microorganisms, 11(10), 2599. https://doi.org/10.3390/microorganisms11102599
Bonamonte, D., Foti, C., Gullo, G., & Angelini, G. (2021). Hyperpigmentation, Hypopigmentation and Discolorations Due to Contactants. In Clinical Contact Dermatitis: A Practical Approach (pp. 353-394). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-49332-5_17
Bond, R., Morris, D. O., Guillot, J., Bensignor, E. J., Robson, D., Mason, K. V., ... & Hill, P. B. (2020). Biology, diagnosis and treatment of Malassezia dermatitis in dogs and cats Clinical Consensus Guidelines of the World Association for Veterinary Dermatology. Veterinary dermatology, 31(1), 27-e4. https://doi.org/10.1111/vde.12809
Brown, A. J. (2023). Fungal resilience and host–pathogen interactions: Future perspectives and opportunities. Parasite Immunology, 45(2), e12946. https://doi.org/10.1111/pim.12946
Chang, C. H., & Stein, S. L. (2024). Malassezia‐associated skin diseases in the pediatric population. Pediatric Dermatology, 41(5), 769-779. https://doi.org/10.1111/pde.15603
Chebil, W., Haouas, N., Chaâbane-Banaoues, R., Remadi, L., Chargui, N., M'rad, S., ... & Babba, H. (2022). Epidemiology of pityriasis versicolor in Tunisia: clinical features and characterization of Malassezia species. Journal of Medical Mycology, 32(2), 101246. https://doi.org/10.1016/j.mycmed.2022.101246
Desquesnes, M., & Dávila, A. M. R. (2002). Applications of PCR-based tools for detection and identification of animal trypanosomes: a review and perspectives. Veterinary parasitology, 109(3-4), 213-231.
Doolan, D. L., Dobaño, C., & Baird, J. K. (2009). Acquired immunity to malaria. Clinical microbiology reviews, 22(1), 13-36. https://doi.org/10.1128/cmr.00025-08
Dyląg, M., Leniak, E., Gnat, S., Szepietowski, J. C., & Kozubowski, L. (2020). A case of anti-pityriasis versicolor therapy that preserves healthy mycobiome. BMC dermatology, 20(1), 9. https://doi.org/10.1186/s12895-020-00106-x
Friedrich, M., & Junak, M. (2017). Assessment of dietary choices of young women in the contexts of hormonal contraceptives. Roczniki Państwowego Zakładu Higieny, 68(1).
Ghosh, S. K., Dey, S. K., Saha, I., Barbhuiya, J. N., Ghosh, A., & Roy, A. K. (2008). Pityriasis versicolor: a clinicomycological and epidemiological study from a tertiary care hospital. Indian journal of dermatology, 53(4), 182-185. https://doi.org/10.4103/0019-5154.44791
Hassan, Z., & Qurtas, D. S. Q. (2024). Epidemiological and Molecular Characterization of Malassezia species from Patients with pityriasis versicolor in Erbil Province: Epidemiological and Molecular Characterization of Malassezia species from Patients with pityriasis versicolor in Erbil Province. Tikrit Journal of Pure Science, 29(3), 8–17. https://doi.org/10.25130/tjps.v29i3.1596
Hube, B., Hay, R., Brasch, J., Veraldi, S., & Schaller, M. (2015). Dermatomycoses and inflammation: The adaptive balance between growth, damage, and survival. Journal de mycologie medicale, 25(1), e44-e58. https://doi.org/10.1016/j.mycmed.2014.11.002
Jalil, M. A., & Yasir, M. H. (2024). Morphological Study of Malassezia Species Isolated from Pityriasis Versicolor Patients in Thi-Qar Governorate and Their Sensitivity to Some Antifungal Drugs. Thi-qar Medical journal, 28(2), 213-224.
Jarman, S. N., Deagle, B. E., & Gales, N. J. (2004). Group‐specific polymerase chain reaction for DNA‐based analysis of species diversity and identity in dietary samples. Molecular Ecology, 13(5), 1313-1322. https://doi.org/10.1111/j.1365-294X.2004.02109.x
Jasiuk, A., Wiekiera, M., Madeja, N., Koziej, S., Niemczuk, M., & Kowalczyk, E. (2025). Diagnosis and Treatment of Pityriasis Versicolor: A Review of Current Methods and Research Findings. Quality in Sport, 44, 62963-62963. https://doi.org/10.12775/QS.2025.44.62963
Johnson, G., Nelson, S., Petric, M., & Tellier, R. (2000). Comprehensive PCR-based assay for detection and species identification of human herpesviruses. Journal of clinical microbiology, 38(9), 3274-3279.
Kurniadi, I., Hendra Wijaya, W., & Timotius, K. H. (2022). Malassezia virulence factors and their role in dermatological disorders. Acta Dermatovenerol Alp Pannonica Adriat, 31(2), 65-70.
Łabędź, N., Navarrete-Dechent, C., Kubisiak-Rzepczyk, H., Bowszyc-Dmochowska, M., Pogorzelska-Antkowiak, A., & Pietkiewicz, P. (2023). Pityriasis versicolor—a narrative review on the diagnosis and management. Life, 13(10), 2097. https://doi.org/10.3390/life13102097
Leung, A. K., Barankin, B., Lam, J. M., Leong, K. F., & Hon, K. L. (2022). Tinea versicolor: an updated review. Drugs in context, 11. https://doi.org/10.7573/dic.2022-9-2
McLoughlin, I. J., Wright, E. M., Tagg, J. R., Jain, R., & Hale, J. D. (2022). Skin microbiome—the next frontier for probiotic intervention. Probiotics and antimicrobial proteins, 14(4), 630-647. https://doi.org/10.1007/s12602-021-09824-1
Mellen, L. A., Vallee, J., Feldman, S. R., & Fleischer, A. B. (2004). Treatment of pityriasis versicolor in the United States. Journal of dermatological treatment, 15(3), 189-192. https://doi.org/10.1080/09546630410032421
Meneghin, A., & Hogaboam, C. M. (2007). Infectious disease, the innate immune response, and fibrosis. The Journal of clinical investigation, 117(3), 530-538.
Merkhofer, R. M., & Klein, B. S. (2020). Advances in understanding human genetic variations that influence innate immunity to fungi. Frontiers in cellular and infection microbiology, 10, 69.
Mulyati, M., Geni, L., Winita, R., & Silitonga, M. F. (2022). Deteksi Jamur Malassezia spp. pada Kulit Pekerja Bangunan di Daerah Sukatani Cimanggis Kota Depok. Anakes: Jurnal Ilmiah Analis Kesehatan, 8(2), 209-222. https://doi.org/10.37012/anakes.v8i2.1200
Naik, B., Sasikumar, J., B, V., & Das, S. P. (2024). Fungal coexistence in the skin mycobiome: a study involving Malassezia, Candida, and Rhodotorula. AMB Express, 14(1), 26. https://doi.org/10.1186/s13568-024-01674-8
Prohic, A., Jovovic Sadikovic, T., Krupalija‐Fazlic, M., & Kuskunovic‐Vlahovljak, S. (2016). Malassezia species in healthy skin and in dermatological conditions. International journal of dermatology, 55(5), 494-504. https://doi.org/10.1111/ijd.13116
Rao, M., Young, K., Jackson-Cowan, L., Kourosh, A., & Theodosakis, N. (2023). Post-inflammatory hypopigmentation: review of the etiology, clinical manifestations, and treatment options. Journal of Clinical Medicine, 12(3), 1243. https://doi.org/10.3390/jcm12031243
Roudbary, M., Vahedi-Shahandashti, R., Santos, A. L. S. D., Roudbar Mohammadi, S., Aslani, P., Lass-Flörl, C., & Rodrigues, C. F. (2022). Biofilm formation in clinically relevant filamentous fungi: a therapeutic challenge. Critical reviews in microbiology, 48(2), 197-221. https://doi.org/10.1080/1040841X.2021.1950121
Saleh, R. M., & Hassan, O. M. (2025). The infectome framework: linking polymicrobial ecology and biofilm dynamics to precision diagnostic approaches. Infection, 1-16. https://doi.org/10.1007/s15010-025-02687-6
Sanders, M. S., van Well, G. T. J., Ouburg, S., Morré, S. A., & van Furth, A. M. (2011). Genetic variation of innate immune response genes in invasive pneumococcal and meningococcal disease applied to the pathogenesis of meningitis. Genes & Immunity, 12(5), 321-334. https://doi.org/10.1038/gene.2011.20
Sharma, V., Kumawat, T. K., Sharma, A., Seth, R., & Chandra, S. (2015). Distribution and prevalence of dermatophytes in semi-arid region of India. Adv Microbiol, 5(2), 93.
Supriadi, M. R., Paramata, N. R., Hasanuddin, A. D. I., Wahjuni, W., & Dungga, E. F. (2024). Identifikasi Pityriasis Versicolor Pada Tenaga Cleaning Service Universitas Negeri Gorontalo. Jambura Axon Medika, 1(1), 35-43.
Tarigan, H., & Graharti, R. (2022). Malassezia Furfur Pada Pitriasis Versikolor Dan Malassezia Folikulitis. Medical Profession Journal of Lampung, 12(1), 31-35. https://doi.org/10.53089/medula.v12i1.444
Thammasit, P., Laliam, A., Chaicumpar, K., Pruksaphon, K., Nosanchuk, J. D., & Youngchim, S. (2023). Differential lipase virulence in Malassezia furfur dimorphism isolated from pityriasis versicolor patients and healthy individuals. Mycoses, 66(6), 540-549. https://doi.org/10.1111/myc.13580
Thoma, W., Krämer, H. J., & Mayser, P. (2005). Pityriasis versicolor alba. Journal of the European Academy of Dermatology and Venereology, 19(2), 147-152. https://doi.org/10.1111/j.1468-3083.2004.01085.x
Van Dyck, K., Pinto, R. M., Pully, D., & Van Dijck, P. (2021). Microbial interkingdom biofilms and the quest for novel therapeutic strategies. Microorganisms, 9(2), 412. https://doi.org/10.3390/microorganisms9020412
Wang, K., Cheng, L., Li, W., Jiang, H., Zhang, X., Liu, S., ... & Li, H. (2020). Susceptibilities of Malassezia strains from pityriasis versicolor, Malassezia folliculitis and seborrheic dermatitis to antifungal drugs. Heliyon, 6(6).
Zhang, Q., & Cao, X. (2019). Epigenetic regulation of the innate immune response to infection. Nature Reviews Immunology, 19(7), 417-432. https://doi.org/10.1038/s41577-019-0151-6