Skin Colonization by Malassezia Species in Neonates: A Prospective Study and Relationship With Neonatal Cephalic Pustulosis | Dermatology | JAMA Dermatology | JAMA Network
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February 2002

Skin Colonization by Malassezia Species in Neonates: A Prospective Study and Relationship With Neonatal Cephalic Pustulosis

Author Affiliations

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.

Arch Dermatol. 2002;138(2):215-218. doi:10.1001/archderm.138.2.215

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.