Superficial skin mycoses are the most common human’s fungal diseases. Their therapy by systemic and local antifungal drugs is effective in most cases. In recent times, the number of cases of ineffective application of antifungal drugs in regimen recommended by clinical guidelines and medicines’ instructions increased. Prescription of therapy schemes involving simultaneous use of several antifungal drugs allows overcoming low effectiveness of antifungal monotherapy. The number of clinical cases of superficial skin mycoses equal 2 was described: malassezia folliculitis (causative agent — Malassezia sympodialis) and disseminated microsporidiosis (causative agent — Microsporum canis), that at first were poorly responded to antifungal therapy, but eventually were completely cured. Malassezia folliculitis in 18-years-old patient, who took 60 mg/day prednisolone calculated as 1 mg/kg/day and 100 mg/day azathioprine due to pyoderma gangrenosum, was cured by combination of solution with 2% sertaconazole and shampoo with 2% ketoconazole and 1% zinc pyrithione. Moreover, after recovery, further use of shampoo with 2% ketoconazole and 1% zinc pyrithione in a preventive treatment regimen, namely 1—2 times per week, while remaining immunosuppressive state associated with the treatment of pyoderma gangrenosum allowed to predict Malassezia folliculitis recurrence. The combination of griseofulvin application, ingested at a dose of 750 mg/day calculated as 22 mg/kg/day, and local therapy by solution with sertaconazole and shampoo with ketoconazole and zinc pyrithione, was effective in disseminated microsporidiosis of smooth skin with damage of lanugo. Combined therapy with the use of medical antifungal two-component shampoo allowed to increase the treatment effectiveness, accelerate patients’ recovery, prevent the distribution of mycotic infection during washing, and the use of antifungal shampoo in a preventive regimen, namely 1—2 times per week, when long-term immunosuppression — to prevent the recurrence of malassezia-folliculitis.

We report a clinicopathologically confirmed case of disseminated Malassezia furfur infection in a neonate with severe surgical pathology and a fatal outcome. Early isolation of M. furfur from non-sterile sites was underestimated, whereas subsequent cultural and histopathological examination of autopsy material confirmed an invasive infection. Yeast cells were detected within and along vessel walls, accompanied by vasculitis, septic “target-like” thrombi, and ischemic and necrotic changes in the lungs, liver, kidneys and heart. Fungal growth was obtained on modified Leeming–Notman agar, and species identification was confirmed by MALDI-TOF MS. Antifungal susceptibility testing revealed high minimal inhibitory concentrations for echinocandins and fluconazole, while amphotericin B, itraconazole, and posaconazole retained activity, which correlated with the lack of clinical response to micafungin and fluconazole. This case emphasizes the potential of M. furfur to cause true invasive disease in neonates and highlights the need for early recognition of Malassezia isolates in high-risk patients. Accurate identification using lipid-supplemented media or molecular techniques and appropriate antifungal selection based on species-specific susceptibility are crucial for optimal management.

Background. There is insufficient data on the antifungal activity of activated zinc pyrithione, which is widely used in practice. Taking into account the reports about a significant role of Malassezia in the pathogenesis of a number of dermatoses, the study of this issue is of scientific, practical interest. Aims. To evaluate the antifungal activity of external forms of activated zinc pyrithione in the treatment of psoriasis, seborrheic dermatitis, pityriasis versicolor. Materials and methods. An open prospective study was conducted between March and July 2022. Patients with psoriasis, seborrheic dermatitis, pityriasis were treated with external forms of activated zinc pyrithione for 21 days. Skin scales and circular prints from lesion foci, as well as from skin areas without clinical manifestations before and after therapy were studied. A quantitative assessment of skin colonization by micromycetes of Malassezia was performed using microscopic, cultural methods of examination. Clinical efficacy and drug safety of the therapy was assessed using the Dermatological Symptom Scale Index, by recording adverse events at weeks 0, 1, 2, 3. Results. 64 patients aged 18 to 65 years with diagnoses of psoriasis, seborrheic dermatitis, and pityriasis versicolor were included. 60 patients completed the study, 4 were excluded due to failure to adhere to the schedule. In patients with seborrheic dermatitis and pityriasis versicolor in the lesion foci after therapy, a significant decrease colonization level according to the results of microscopic, cultural studies was observed. In psoriasis patients, a significant decrease in the colonization level was obtained only based on the results of microscopic examination. In all groups, significant differences in comparison to the initial level were registered already at the 1st week of treatment. No adverse events were registered. Conclusion. Activated zinc pyrithione in the form of cream and aerosol showed moderate antifungal activity against micromycetes of the genus Malassezia.

Introduction . Frequent hospitalization of immunocompromised patients, the use of invasive devices, and antibacterial therapy contribute to the nosocomial spread of invasive candidiasis pathogens, including hospital outbreaks. Objective . To characterize, based on published data, the epidemiological features of healthcare-associated outbreaks of invasive candidiasis caused by different yeast species and the measures used for their control. Materials and methods . We analyzed data from online databases (Outbreak Database, PubMed, eLibrary) using the keywords “Candida,” “outbreak,” “nosocomial,” and “healthcare-associated infections”. Results . A total of 82 outbreaks reported between 1977 and 2025 were included. The etiological profile of published outbreaks shifted from the predominance of C. albicans to the dominance of C. parapsilosis and, since 2016, C. auris. Outbreaks caused by C. auris and C. parapsilosis were characterized by prolonged duration and a wide range of contributing factors. Outbreaks caused by fluconazole-resistant strains were associated with longer duration and higher mortality. The main transmission factors included healthcare workers’ hands and parenteral nutrition solutions. The most effective control measures included epidemiological surveillance, hand hygiene monitoring, thorough environmental decontamination, isolation and restriction measures, and specialized strategies for C. auris. Conclusion . Healthcare-associated outbreaks of invasive candidiasis caused by different yeast species differ in duration, mortality, and transmission patterns depending on the pathogen species and their susceptibility to antifungal agents. Their prevention and control depend on timely detection of colonized and infected patients, species-level identification of the pathogen, and appropriate selection of infection control measures depending on the pathogen species.

Tinea nigra (черный микоз) — редкий микоз кожи, распространен в эндемических районах — Латинской Америке, Южной Африке, Юго-Восточной Азии, Индии и некоторых других странах. На территории Европы Tinea nigra не встречается. Единичные научные публикации описывают редкие случаи завоза черного микоза в Испанию и Великобританию. До настоящего времени не было публикаций, посвященных обнаружению Tinea nigra в Российской Федерации. Описан впервые выявленный Tinea nigra у мужчины в возрасте 25 лет, жителя Санкт-Петербурга. Заражение произошло на острове Шри-Ланка в результате небольшой травмы кисти. Три темноокрашенных пятна появились на ладони и пальцах правой кисти. Дерматоскопия очагов показала, что признаков меланоцитарного образования нет: отсутствуют структуры борозд и гребней. На фоне неравномерной коричневатой пигментации диффузно разбросаны коричневые точки, линейные, нитевидные структуры (спикулы, spicules). В результате микологического исследования при микроскопии с КОН выявлены короткие, изогнутые, часто септированные, широкие, пигментированные гифы, при посеве получен рост культуры Hortaea werneskii. Идентификация возбудителя подтверждена результатами молекулярно-генетического секвенирования. Пациент успешно вылечен кремом с сертаконазолом. Через 4 нед непрерывной терапии достигнуто полное как микологическое, так и клиническое выздоровление. Сертаконазол — антимикотик широкого спектра действия, относящийся к производным имидазола, дает выраженный фунгицидный эффект по отношению к большинству возбудителей микозов кожи. Сертаконазол оказался эффективным в терапии Tinea nigra.

   Objective.  To characterize the epidemiological and microbiological features of fungal colonization and infections in neonates.    Materials and methods. An observational epidemiological study was conducted. It comprised a retrospective, single-center analysis of microbiological surveillance data from 2001 to 2025, a prospective, single-center study of fungal colonization and infections from 2021 to 2025, and a multicenter analysis of clinically significant fungal infections in neonates across three hospitals in Saint Petersburg.    Results.  During 2021–2025, 376 cases of fungal infections in neonates were identified in three hospitals. Outbreak-associated cases predominated and accounted for 82.2 % of all infections. Вloodstream infections and catheter-associated bloodstream infections accounted for 85 %. The leading pathogen was Candida parapsilosis, responsible for 40 % of infections. Compared with C. albicans, C. parapsilosis was more frequently associated with invasive infections, bloodstream infections, and catheter-associated bloodstream infections. Positive correlation between the rate of episodes detected on admission and hospital-acquired episodes was revealed, with C. albicans predominating in both groups (r = 0.76). In the prospective, single-center study, colonization accounted for 89.0 % of cases, while 60.3 % were hospital-acquired. Malassezia furfur was detected in 6.1 % of cases and was associated with late hospital-acquired detection.    Conclusions.  Fungal colonization and infections in neonates demonstrate species-specific epidemiological patterns. Hospital spread of C. albicans was mainly associated with strains introduced by colonized patients on admission. In contrast, C. parapsilosis showed hospital transmission and accounted for a substantial proportion of invasive infections and outbreak-associated cases. Detection of M. furfur and other rare yeasts highlights the need for expanded etiological diagnostics in high-risk neonatal units.