Granulomatous skin infection caused by Malassezia pachydermatis in a dog owner.

Background: Malassezia pachydermatis is part of the normal cutaneous microflora of dogs and many other mammals. M pachydermatis has not yet been reported as an agent that causes skin infection in humans, although it has been found to cause fungemia and other nosocomial infections in preterm newborns and immunocompromised adults.

Observations: Malassezia pachydermatis was isolated from the facial granuloma of a healthy woman and her dog's skin scrapings and cerumen. The yeast identity was established by standard methods and scanning electron microscopy. A skin biopsy specimen showed chronic inflammatory granuloma, numerous purple-red round or ovoid spores in the superficial necrotic tissue, and sparse red spores in the dermis. The skin lesions healed after oral fluconazole and cryotherapy.

Conclusions: Definite diagnosis of M pachydermatis-induced skin infection principally depends on the results of fungal culture and histologic examination, and the combination of oral fluconazole and adjunctive cryotherapy seems to be an effective therapeutic regimen.