The association between Malassezia spp. And pruritus in facial acne vulgaris

Background Acne vulgaris (AV) is a chronic inflammatory condition involving the pilosebaceous unit. Recent studies have shown that itching of mild-to-moderate severity is relatively common in patients with acne. Malassezia spp. is normal flora of skin surface, and can be found in acne lesions. Aim: To clarify the relationship between Malassezia spp. in facial acne lesions and their association with pruritus symptom. Methods This is a cross-sectional study conducted at dermatology and venereology outpatient clinic in a tertiary hospital in Indonesia. We recruited subjects with at least four inflammatory and four noninflammatory facial acne lesions. Acne was graded using Lehmann's criteria, and pruritus was graded using visual analog scale (VAS). Follicular content of acne lesions was collected for microscopic examination and fungal culture. Results Of the 120 subjects, 46 (38.3%) reported experiencing itching in acne lesions. Pruritus was more common in patients with mild AV. Among those with pruritus, fungal spore was found in 60.6% subjects. There was no statistically significant difference in terms of the presence and severity of pruritus and presence of Malassezia spp. determined by culture (p=0.332; 0.317). Conclusion Pruritus may accompany facial acne lesions. In this study, the presence and severity of pruritus did not correlate with the presence of Malassezia spp. in facial acne lesions.