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Veterinary Dermatology 2004, 15 , 53–56

Blackwell Publishing Ltd.

Case report Seborrhoeic dermatitis in a goat due to Malassezia pachydermatis

DIDIER PIN

223, chemin de Leysotte, 33400 Talence, France

( Received 28 May 2003; accepted 12 September 2003)

Abstract A 6-year-old female goat was presented with a seborrhoeic dermatosis of 5 months duration. The condition developed following a severe enteritis associated with weight loss. Dermatological examination showed a generalized greasy seborrhoeic dermatosis, which spared the head and extremities of the limbs. Microscopic examination of impression smears of lesional skin revealed numerous yeasts typical of Malassezia sp. Culture on Sabouraud’s dextrose agar yielded Malassezia pachydermatis growth. Histopathological examination of haematoxylin/eosin and safranin (HES) stained sections of biopsies showed mild lymphocytic superficial perivas- cular hyperplastic dermatitis. Numerous budding yeasts were visible both on the surface, and follicular keratin, in HES and periodic acid Schiff (PAS) stained sections. A dramatic response was observed after 1 week of a topi- cal anti- Malassezia treatment, and the resolution of the condition was complete after 4 weeks.

Keywords : dermatomycosis, goat, Malassezia dermatitis, skin.

INTRODUCTION

Yeasts of the genus Malassezia are lipophilic organisms that are considered to be saprophytes of normal mam- malian and avian skin, 1 and are frequently recovered from the skin of warm-blooded vertebrates. Currently, the genus includes seven species: six are lipid-dependent,

and one, M. pachydermatis , is nonlipid-dependent. 2 A case

of presumptive localized Malassezia dermatitis has been

described in goats. 3 To date, only lipid-dependent Malassezia species have been isolated from the skin

of goats. 4 This report documents a case of Malassezia

dermatitis in a goat caused by M. pachydermatis .

CASE

A 6-year-old female goat was presented with a sebor-

rhoeic dermatosis of 5 months’ duration. The condi- tion followed a severe enteritis associated with weight loss, appeared on the back and spread progressively to involve the trunk. There were no other animals in the environment and human contamination was not reported. The goat was fed on grass, hay and bread. On physical examination, the goat appeared in good general health. The mucous membranes were normal and no lymphadenomegaly was noted. The faeces were of normal appearance. Pruritus was absent. Dermatological examination showed a generalized

Correspondence: Didier Pin, Unité de Dermatologie, Service d’Anatomie Pathologique. Ecole Nationale Vétérinaire de Lyon BP 83, 1 Avenue Bourgelat, 69280 Marcy L’Etoile, France. E-mail:

dpin_vetderm@hotmail.com

© 2004 European Society of Veterinary Dermatology

greasy seborrhoeic dermatosis, which spared the head and extremities of the limbs (Fig. 1). The coat was dull and easily epilated and widespread multifocal alopecia was present (Fig. 2). The lesions included erythema, hyperpigmentation, mild lichenification, large scales and follicular casts. The differential diagnoses included ectoparasite infestations such as demodicosis, pediculosis and cho- rioptic mange; dermatophytosis; yeast dermatitis; nutritional disease, particularly vitamin E/selenium- responsive dermatosis; and effluvium telogen. Multiple skin scrapings and coat brushings failed to reveal any parasites. Direct examination of hairs and Wood’s lamp examination were negative for der- matophytes. Microscopic examination of impression smears of lesional skin, using the tape-strip technique, revealed numerous spherical or oval-shaped yeasts with unipolar budding and a distinct collarette, typical of Malassezia sp. (Fig. 3). Samples of surface material, collected using sterile swabs rubbed on lesional skin, were taken and inoculated onto Sabouraud’s dextrose agar with gentamycin and incubated at 32 ° C. After 2 days, round, small, smooth and creamy white colo- nies began to form on the surface of the plate. Micro- scopic examination of one of these colonies showed yeasts with the typical morphology of Malassezia. 5 Unfortunately, after a further day, a heavy mixed growth of various fungi covered the surface of the plate. Microscopic examination of the filamentous fungi did not reveal dermatophytes. Subcultures for further identification of the yeasts proved unsuccess- ful. Furthermore, tentative identification, by mean of polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) using paraffin embed-

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D. Pin

54 D. Pin Figure 1. View of seborrhoeic dermatosis. the trunk of the goat showing a

Figure 1. View of

seborrhoeic dermatosis.

the trunk of

the goat showing a generalized

dermatosis. the trunk of the goat showing a generalized Figure 2. Closer view of the trunk

Figure 2. Closer view of the trunk showing the greasy seborrhoea, the dull coat and the multifocal alopecia.

seborrhoea, the dull coat and the multifocal alopecia. Figure 4. Photomicrograph showing a lymphocytic

Figure 4. Photomicrograph showing a lymphocytic superficial, perivascular, hyperplastic, and spongiotic dermatitis (×63, HES).

hyperplastic, and spongiotic dermatitis ( × 63, HES). Figure 3. Photomicrograph of an impression smear from

Figure 3. Photomicrograph of an impression smear from lesional skin showing oval-shaped yeasts with unipolar budding and a distinct collarette, typical of Malassezia sp. (×1000, eosin-blue-RAL 555).

ded biopsies was also unsuccessful. Histopathological examination of HES-stained sections of biopsies, obtained from lesional skin on the trunk, showed a marked orthokeratotic, focally parakeratotic, hyperk- eratosis, an irregular epidermal hyperplasia with mild spongiosis and a mild lymphocytic superficial perivas- cular dermatitis (Fig. 4). Hair follicles were dilated and plugged with keratin and often devoid of hairs. Numerous budding yeasts were visible both in the sur-

© 2004 Blackwell Publishing Ltd, Veterinary Dermatology , 15 , 53–56

Publishing Ltd, Veterinary Dermatology , 15 , 53–56 Figure 5. Photomicrograph showing numerous budding yeasts

Figure 5. Photomicrograph showing numerous budding yeasts in follicular keratin (×1000, HES).

face, and follicular keratin, in HES- and PAS-stained sections (Fig. 5). A tentative diagnosis of Malassezia dermatitis was made. The treatment consisted of weekly baths in a chlorhexidine containing shampoo (Pyoderm® Vir- bac), followed by the application of a 0.2% solution of enilconazole (Imaveral® Janssen-Cilag), for 4 weeks. A dramatic response was observed after 1 week and resolution of the condition was complete after 4 weeks. Seven weeks later, the goat’s coat was normal (Fig. 6)

Generalized Malassezia dermatitis in a goat

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Generalized Malassezia dermatitis in a goat 55 Figure 6. View of the trunk of the goat,

Figure 6. View of the trunk of the goat, 7 weeks after the diagnosis and treatment, showing normal coat.

and cytological examination of the skin failed to reveal any yeasts. No recurrence was observed for a 6-month follow-up period. Based on the historical and clinical findings, cytological and histopathological evidence of Malassezia overgrowth, growth of Malassezia sp. colo- nies on Sabouraud’s dextrose agar, and a dramatic response to antifungal treatment combined with cyto- logical absence of Malassezia , the final diagnosis was Malassezia dermatitis due to Malassezia pachydermatis .

DISCUSSION

Malassezia spp. yeasts have been isolated from the skin of a variety of mammals and birds and have been shown to induce disease in various species including man, dog, cat, horse, rhinoceros, black bear and Cali- fornia sea lion. 4,611 To the author’s knowledge, no case of generalized Malassezia dermatitis has been reported in the goat. Malassezia slooffiae has been isolated from the external ear canal of healthy goats. 4 An outbreak of presumptive tinea versicolor was reported in a herd of milking goats. 3 The lesions consisted of annular areas of hypo- or hyperpigmentation with scaling margins on the teats and udder. No cytological examination was performed. On histopathological examination, PAS- positive short, slightly curved structures associated with clusters of oval or round thick-walled spores, were seen in the epidermis. However, the causal fungus of tinea versicolor in humans ( Malassezia furfur ) could not be cultured. Anecdotally, Scott reported a case of yeast dermatitis in a goat, 12 clinically (a nonpruritic, generalized, symmetrical dermatitis, characterized by diffuse alopecia, scaling, crusting, greasiness and lichenification) cytologically (numerous budding yeasts) and histopathologically (a mild superficial perivascular dermatitis with marked orthokeratotic and parakeratotic hyperkeratosis and dilated and plugged hair follicles) very similar to the case reported here. Fungal cultures were negative. The diagnosis was candidiasis, based on the presence of numerous bud- ding yeasts and pseudohyphae in direct smears and skin biopsy specimens.

This report documents a case of Malassezia derma- titis in a goat. The diagnosis was based on the presence of elevated Malassezia populations on lesional skin and the good clinical and mycological response to topical antifungal therapy. Culture on Sabouraud’s dextrose agar yielded Malassezia growth. To date, as Malassezia pachydermatis is the only species of Malas- sezia that will readily grow on Sabouraud’s dextrose agar, the causative Malassezia organism must be M. pachydermatis . No further identification, by means of physiological or genetic characteristics, was possible because the growing yeast was swamped by other fun- gal elements present on the skin of the goat. In this goat, cytological examination showed yeasts of variable morphology with long, cylindrical, ovoid or globose cells, suggesting that several species of Malas- sezia might have been present on its skin. Among them, only a nonlipid-dependent species might have been iso- lated, because of the culture techniques employed. In a study of 47 wild-type isolates of the genus Malassezia , isolated from dogs and cats, 13 > 80% of cultures were mixed, comprising two or three Malassezia species , including M. pachydermatis , M. furfur and M. sympodialis . However, the methodology in this study has been criticized and, according to Guéhot and Guillot, 14 variable morphology more likely indicates phenotypic differences within the Malassezia pachy- dermatis species than mixed populations. The condition observed in this goat was very similar, clinically and histopathologically, to the signs seen in dogs with Malassezia dermatitis: an erythematous greasy seborrhoeic dermatitis and superficial perivas- cular hyperplastic dermatitis, respectively. The single difference is the absence of pruritus in the goat. Because of the opportunistic behaviour of Malassezia organisms, infection only occurs when there are changes in the cutaneous environment or defence mechanisms. 15 The conditions that influence the change from commen- sal to pathogen in the yeast are not fully understood. In the dog, predisposing factors include increased cut- aneous relative humidity, changes in skin surface lipids, allergies, endocrinopathies, metabolic disorders and chro- nic glucocorticoid therapy. 15,16 In this goat, the condition developed following a severe intestinal disorder, which caused malnutrition and might have been a predisposing factor. Furthermore, the fact that topical medications alone were very effective and that no relapse was ob- served for a 6-month period, suggests that this was a secondary Malassezia dermatitis.

CONCLUSION

To the author’s knowledge, this is the first report of Malassezia dermatitis in a goat with cytological and histopathological evidence of Malassezia overgrowth and Malassezia colonies grown on Sabouraud’s dex- trose agar. This condition was caused, at least in part, by a nonlipid-dependent Malassezia species ( Malas- sezia pachydermatis ). Malassezia dermatitis must be

© 2004 European Society of Veterinary Dermatology, Veterinary Dermatology , 15 , 53–56

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included in the differential diagnosis of seborrhoeic disorders in goats.

ACKNOWLEDGEMENTS

The author thanks Dr Jacques Guillot for the attempt to tentatively identify the strain by PCR–RFLP.

REFERENCES

1. Midgley, G., Guého, E., Guillot, J. Diseases caused by Malassezia species. In: Collier, L., ed. Topley and

Wilson’s Microbiology and Microbial Infections , Vol. 4 Medical Mycology, Part IV Superficial Basidiomy- cetous Yeasts , 9th edn. London: Arnold, 1998: 201–

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2. Guého, E., Midgley, G., Guillot, J. The genus Malassezia with description of four new species. Antonie Van Leeu- wenhoek 1996; 69 : 337–55.

3. Bliss, E.L. Tinea versicolor dermatomycosis in the goat. Journal of the American Veterinary Medical Association 1984; 184 : 1512–13.

4. Guillot, J., Guého, E., Mialot, M. et al. Importance des levures du genre Malassezia en dermatologie vétérinaire. Le Point Vétérinaire 1998; 29 : 691–701.

5. Guillot, J., Guého, E., Lesourd, M. et al. Identification of Malassezia species. A practical approach. Journal de Mycologie Médicale 1996; 6 : 103–10.

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Guillot, J., Chermette, R., Guého, E. Prévalence du genre Malassezia chez les Mammifères. Journal de Mycologie Médicale 1994; 4 : 72–9.

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Bond, R. Malassezia spp in horses: background to an evolving subject in dermatology. Equine Veterinary Edu- cation 2002; 14 : 123–5.

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Nell, A., James, S.A., Bond, C.J. et al. Identification and distribution of a novel Malassezia species yeast on nor- mal equine skin. Veterinary Record 2002; 150 : 395–8.

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Guillot, J., Bond, R. Malassezia pachydermatis : a review. Medical Mycology 1999; 37 : 295–306.

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Salkin, I.F., Gordon, M.A., Stone, W.B. Pityrosporum pachydermatis in a black bear ( Ursus americanus ). Sab- ouraudia 1978; 16: 35–8.

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Guillot, J., Petit, T., Degorce-Rubiales, F. et al. Dermati- tis caused by Malassezia pachydermatis in a California sea lion (Zalophus californianus). Veterinary Record 1998; 142: 311–12.

12.

Scott, D.W. Large Animal Dermatology. Philadelphia:

W.B. Saunders, 1988: 182–5.

13.

Raabe, P., Mayser, P., Weiß, R. Demonstration of Malassezia furfur and M. sympodialis together with M. pachydermatis in veterinary specimens. Mycoses 1998; 41: 493–500.

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Guého, E., Guillot, J. Comments on Malassezia species from dogs and cats. Mycoses 1999; 42: 673–4.

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Matousek, J.L., Campbell, K.L. Malassezia dermatitis. Compendium on Continuing Education 2002; 24: 224–31.

16.

Scott, D.W., Miller, W.H. Jr, Griffin, C.E. Muller and Kirk’s Small Animal Dermatology, 6th edn. Philadelphia:

W.B. Saunders, 2001: 363–74.

Résumé Une chèvre âgée de 6 ans a été présentée pour une dermatose séborrhéique évoluant depuis 5 mois. La mal- adie est apparue à la suite d’une entérite sévère s’accompagnant d’une perte de poids. L’examen dermatologique a montré une dermatose séborrhéique généralisée, épargnant toutefois la tête et l’extrémité des membres. L’examen microscopique de calques cutanés a montré de nombreuses levures, typiques de Malassezia sp. Une culture sur milieu de Sabouraud a permis la pousse de colonies de Malassezia pachydermatis. L’examen histopathologique de biopsies colorées à l’hématéine éosine safran a montré une dermatite hyperplasique et un infiltrat inflamma- toire périvasculaire lymphocytaire. De nombreuses levures bourgeonnantes étaient visibles en surface et dans la kératine folliculaire sur les biopsies colorées à l’HES et après réaction au PAS. Une réponse rapide a été notée après une semaine d’un traitement anti-Malassezia topique, et une guérison complète a été observée après 4 semaines.

Resumen Una hembra de cabra de 6 años se presentó con una dermatosis seborreica de 5 meses de duración. El cuadro se desarrolló tras una enteritis grave asociada a pérdida de peso. El examen dermatológico mostró una der- matosis seborreica oleosa generalizada, que respetaba la cabeza y las porciones distales de las extremidades. El examen microscópico de improntas de la piel lesionada revelaba numerosas levaduras típicas de Malassezia sp. El cultivo en agar Sabouraud con dextrosa produjo un crecimiento de Malassezia pachydermatis. El examen histopa- tológico de biopsias teñidas con hematoxilina/eosina y safranina (HE & S) mostró una dermatitis hiperplásica perivascular superficial linfocítica leve. Se identificaron numerosas levaduras en gemación tanto en la queratina superficial como folicular, en secciones teñidas con HE & S y PAS. Se observó una respuesta espectacular después de una semana de tratamiento tópico anti-Malassezia, y la resolución del proceso fue completa después de 4 semanas.

Zusammenfassung Eine 6 Jahre alte Ziege wurde mit einer seborrhoeischen Dermatitis von 5-monatiger Dauer vorgestellt. Die Krankheit entwickelte sich im Anschluss an eine ernste Enteritis, die mit Gewichtsverlust einherging. Bei der dermatologischen Untersuchung zeigte sich eine generalisierte ölige seborrhoeische Dermatitis, die nur Kopf und Extremitäten verschonte. Mikroskopische Untersuchung von Abklatschpräparaten veränderter Haut zeigte zahlreiche Hefepilz-Organismen, die das typische Aussehen von Malassezia sp. hatten. Kultur auf Sabouraud- Dextrose-Agar zeigte Wachstum von Malassezia pachydermatis. Histopathologische Untersuchung von mit Hämatoxylin/Eosin und Safranin (HE&S) gefärbten Schnitten von Biopsien zeigten eine geringgradige, ober- flächliche, lymphozytische, perivaskuläre hyperplastische Dermatitis. Zahlreiche sprossende Hefepilzorganismen waren sowohl an der Oberfläche als auch im follikulären Keratin in HE&S als auch periodic acid Schiff (PAS) gefärbten Schnitten zu sehen. Eine dramatische Verbesserung konnte nach 1 Woche topischer Therapie mit Malassezia- wirksamer Behandlung beobachtet werden und nach 4 Wochen war die Erkrankung vollständig abgeheilt.

© 2004 Blackwell Publishing Ltd, Veterinary Dermatology , 15 , 53–56

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