Cutaneous fungal microbiome: Malassezia yeasts in seborrheic dermatitis scalp in a randomized, comparative and therapeutic trial

Figures & data

Table 1. Fungal species identified on scalp samples population study overall (n = 87).

Isolated species	N (%)
M. globosa	40 (45.8)
M. restricta	26 (29.8)
M. sympodialis^§	7 (8.0)
M. dermatis^§	3 (3.4)
M. furfur	2 (2.3)
M. japonica	2 (2.3)
M. slooffiae	1 (1,1)
Non- Malassezia species	5 (5.7)

Non-Malassezia species: T. asteroids, T.faecales, Rhodotorula spp., C. haemulonis var. vulnera and C. parapsilosis.

One without growth.

^§ ITS-rDNA region identification.

Table 2. Distribution of yeasts of Malassezia spp. at the baseline and six month after treatment including all subjects (n = 81 samples).

Species (isolates)	Baseline N(%)	Month 6 N(%)
M. dermatis^§	1 (2.3)	2 (5.6)
M. furfur	1 (2.3)	1(1.8)
M. globosa	24 (55.8)	16(44.4)
M. japonica	1 (2.3)	1 (2.8)
M. restricta	10 (23.3)	14 (38.9)
M. sloofiae	0 (0)	1(2.8)
M. sympodialis^§	6 (14)	1 (2.8)

^§ ITS-rDNA region identification.

Table 3. Distribution of yeasts of Malassezia spp. at the baseline and six month after treatment in seborrheic dermatitis subjects (n = 81 samples).

Species (isolates)	Baseline N(%)	Month 6 N(%)
M. globosa	24 (29.6)	16(19.7)
M. restricta	10 (11.3)	14 (17.3)

Table 4. Baseline characteristics in subjects according to yeasts of Malassezia genus.

Variables	M. globosa (n = 24)	M. restricta(n = 10)	p
Demographic
Age, years, mean ± SD	28.5 ± 5.6	28.3 ± 7.2	0,985
Female, n (%)	17 (70.8)	7(70)	1,000
Clinical diagnosis
Seborrheic dermatitis, n (%)	20 (83.3)	6 (60.0)	0,309
Seborrhoea, n(%)	4 (16.7)	4 (40.0)
Clinical severity
Moderate level, n (%)	22(91.7)	10 (100)	0.888
Severe level, n(%)	2 (8.3)	0 (0.0)
Treatment group
ISO group, n (%)	13(54.2)	7 (70.0)	0,637
SH group, n(%)	11(45.8)	3(30.0)
Laboratorial
Sebum secretion rate, ug/cm2, mean ± SD	127.8 ± 48	121.5±31.6	0.615

SD: standard deviation.

ISO: low-dose oral isotretinoin therapy.

SH: topical therapy with anti-seborrheic shampoo.

Table 5. Identification of Malassezia spp. strains obtained from patients before and after treatment based on molecular methods (internal transcribed spacer region, ITS-rDNA and D1/D2-28S-rDNA sequencing).

	Molecular Identification
Strain number	Yeast ID	Maximum ID (%)	Yeast ID	Maximum ID (%)
1	M. globosa	99%	M. globosa	99%
1F	M. japonica	99%	M. japonica	100%
2	M. globosa	98%	M. globosa	99%
2F	M. globosa	99%	M. globosa	99%
3	M. globosa	99%	M. globosa	98%
3F	M. restricta	99%	M. restricta	99%
4	M. restricta	99%	M. restricta	98%
4F	M. restricta	99%	M. restricta	99%
5	M. restricta	100%	M. restricta	99%
5F	M. globosa	99%	M. globosa	100%
6F	M. restricta	99%	M. restricta	99%
7	M. restricta	99%	M. restricta	99%
7F	M. restricta	99%	M. restricta	99%
8	M. sympodialis	99%	M. sympodialis / M. dermatis	99%
9	M. furfur	99%	M. furfur	99%
10	M. globosa	99%	M. globosa	99%
10F	M. globosa	99%	M. globosa	99%
11	M. restricta	99%	M. restricta	99%
11F	M. restricta	99%	M. restricta	99%
12	M. globosa	99%	M. globosa	99%
12F	M. restricta	99%	M. restricta	99%
13	M. japonica	99%	M. japonica	100%
13F	M. globosa	98%	M. globosa	99%
15	M. globosa	98%	M. globosa	99%
15F	M. slooffiae	99%	M. slooffiae	100%
16	M. globosa	99%	M. globosa	100%
16F	M. globosa	99%	M. globosa	98%
17	M. globosa	99%	M. globosa	100%
17F	M. globosa	98%	M. globosa	99%
19	M. globosa	98%	M. globosa	99%
19F	M. restricta	99%	M. restricta	99%
20	M. sympodialis	99%	M. sympodialis	100%
20F	M. globosa	99%	M. globosa	99%
21	M. restricta	99%	M. restricta	99%
21F	M. furfur	99%	M. furfur	100%
23	M. globosa	99%	M. globosa	100%
23F	M. restricta	99%	M. restricta	99%
24	M. sympodialis	99%	M. sympodialis	100%
24F	M. globosa	99%	M. globosa	99%
25	M. restricta	99%	M. restricta	99%

	Identificação molecular – região ITS-rDNA		Identificação molecular – D1/D2 da região 28S-rDNA
N° Paciente	Yeast ID	Maximum ID (%)	Yeast ID	Maximum ID (%)
25F	M. restricta	99%	M. restricta	99%
27	M. globosa	98%	M. globosa	98%
28	M. restricta	99%	M. restricta	99%
29	M. globosa	99%	M. globosa	99%
29F	M. dermatis	99%	M. dermatis/M. sympodialis	98%
30	M. globosa	99%	M. globosa	99%
30F	M. globosa	100%	M. globosa	99%
31	M. globosa	99%	M. globosa	99%
31F	M. globosa	99%	M. globosa	99%
32	M. globosa	99%	M. globosa	100%
32F	M. sympodialis	100%	M. sympodialis	100%
33	M. restricta	99%	M. restricta	99%
33F	M. restricta	99%	M. restricta	99%
35	M. globosa	99%	M. globosa	99%
36	M. globosa	98%	M. globosa	99%
37	M. globosa	98%	M. globosa	100%
37F	M. globosa	98%	M. globosa	99%
38	M. globosa	98%	M. globosa	99%
38F	M. restricta	99%	M. restricta	100%
39	M. sympodialis	99%	M. sympodialis	99%
39F	M. restricta	99%	M. restricta	99%
40	M. globosa	99%	M. globosa	100%
40F	M. restricta	99%	M. restricta	99%
42	M. restricta	97%	M. restricta	99%
43	M. globosa	99%	M. globosa	99%
43F	M. globosa	99%	M. globosa	99%
44	M. globosa	98%	M. globosa	99%
44F	M. globosa	99%	M. globosa	99%
45	M. globosa	99%	M. globosa	99%
45F	M. globosa	99%	M. globosa	99%
46F	M. restricta	99%	M. restricta	99%
47	M. sympodialis	100%	M. sympodialis	100%
47F	M. restricta	<90%	M. restricta	99%
48	M. restricta	100%	M. restricta	100%
48F	M. globosa	99%	M. globosa	99%
51	M. sympodialis	100%	M. sympodialis/ M.dermatis	99%
51F	M. restricta	<90%	M. restricta	99%
52	M. globosa	98%	M. globosa	100%
52F	M. globosa	98%	M. globosa	99%
54	M. dermatis	99%	M. dermatis/M. sympodialis	99%
54F	M. dermatis	99%	M. dermatis/M. sympodialis	99%

ID =Identity (chance of similarity between sequences with those of gene bank); E value= Probability of alignment occurred by chance; 6= T. asteroides; 14=T.faecales; 14F= Rhodotorula spp., 9F= C. haemulonis var. vulnera, 27F=without growth; 46F = C. parapsilosis; 8F, 28F, 35F, 36F, 42F= dropout; 40Do= dorsal region (M. sympodialis); 40Lo= lombar region (M. globosa).