Frequency and spectrum of Malassezia yeasts in the area of the prepuce and glans penis.

OBJECTIVE: To investigate the frequency and spectrum of lipophilic Malassezia yeasts within the area of the glans penis and preputial space in healthy men, most of whom were uncircumcised.

SUBJECTS AND METHODS: As the glans penis and the prepuce are abundant in sebaceous glands, 130 clinically healthy men were examined for the presence of Malassezia spp. Two impression preparations each were made on modified Dixon (mDixon) and Leeming-Notman agar. The media were used with no added cycloheximide to allow the identification of the full spectrum of Candida yeasts. After 10 days of incubation at 32 degrees C Malassezia and Candida yeasts were differentiated by micromorphological and biochemical criteria.

RESULTS: Malassezia spp. were found as part of the microflora of the glans penis in 49% of the men. The two media yielded comparable results for isolation frequency and spectrum: On mDixon agar, 47.6% of the isolates were identified as M. sympodialis, 42.8% as M. globosa, 4.8% as M. pachydermatis and 2.4% as M. furfur. Candida spp. (especially C. albicans) were found in 20.8%. There were no significant differences in the distribution of different Malassezia spp with age.

CONCLUSIONS: Malassezia yeasts may belong to the resident microflora of the male genital region, which is supported by the finding that free sebaceous glands ('Tyson's glands') normally occur at this site. They may also be involved in pathological processes of the glans penis, e.g. balanitis, seborrheic eczema or psoriasis.