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Multicenter Study
. 2003 Mar;148(3):479-88.
doi: 10.1046/j.1365-2133.2003.05093.x.

Atopy patch test reactions to Malassezia allergens differentiate subgroups of atopic dermatitis patients

C Johansson  1 , M H Sandström, J Bartosik, T Särnhult, J Christiansen, A Zargari, O Bäck, C F Wahlgren, J Faergemann, A Scheynius, M Tengvall Linder
Affiliations
Multicenter Study

Atopy patch test reactions to Malassezia allergens differentiate subgroups of atopic dermatitis patients

C Johansson et al. Br J Dermatol. 2003 Mar.

Abstract

Background: The yeast Malassezia is considered to be one of the factors that can contribute to atopic dermatitis (AD).

Objectives: To investigate the reactivity to Malassezia allergens, measured as specific serum IgE, positive skin prick test and positive atopy patch test (APT), in adult patients with AD.

Methods: In total, 132 adult patients with AD, 14 with seborrhoeic dermatitis (SD) and 33 healthy controls were investigated for their reactions to M. sympodialis extract and three recombinant Malassezia allergens (rMal s 1, rMal s 5 and rMal s 6).

Results: Sixty-seven per cent of the AD patients, but only one of the SD patients and none of the healthy controls, showed a positive reaction to at least one of the Malassezia allergens (extract and/or recombinant allergens) in at least one of the tests. The levels of M. sympodialis-specific IgE in serum correlated with the total serum IgE levels. Elevated serum levels of M. sympodialis-specific IgE were found in 55% and positive APT reactions in 41% of the AD patients with head and neck dermatitis. A relatively high proportion of patients without head and neck dermatitis and patients with low total serum IgE levels had a positive APT for M. sympodialis, despite lower proportions of individuals with M. sympodialis-specific IgE among these groups of patients.

Conclusions: These results support that Malassezia can play a role in eliciting and maintaining eczema in patients with AD. The addition of an APT to the test battery used in this study reveals a previously overlooked impact of Malassezia hypersensitivity in certain subgroups of AD patients.

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