Abstract
Introduction
Acne vulgaris (AV) is a common dermatological disorder largely known and well managed by dermatologists and aestheticians. However, there are many cases of unresponsive treatment for such conditions. Little is known about the cause of AV treatment resistance, which is fungal infection in which the cutaneous findings are indistinguishable from those of AV.
Case Presentation
A 31-year-old Cambodian male patient complained of on-and-off bothersome pruritus and generalized rashes on his back and shoulders for 10 years. He mentioned that pruritus intensifies during the summer more than during the winter. He had been treated for truncal acne—AV at other clinics—for five years, with only slight improvement. We prescribed oral antifungal, oral anti-pruritus, topical keratolytic, and antifungal soaps to the patients. Nearly 70% of symptom improvement was reported.
Conclusion
When a patient is diagnosed with AV and is unresponsive to treatment within one month, reevaluation of cutaneous findings and symptoms is mandatory because Malassezia folliculitis is most likely masking behind AV.