Malassezia in Immunocompromised Hosts: Mechanistic Insights into Its Pathogenic Transformation and Clinical Manifestations

Background Malassezia is a lipid-dependent yeast that forms an integral part of the skin microbiome but can cause a wide range of cutaneous and systemic diseases in immunocompromised hosts, including individuals with HIV, diabetes, Parkinson’s disease, and those undergoing immunosuppressive therapy. Case Presentation We analyzed case reports that illustrate the clinical manifestations of Malassezia in immunosuppressed patients and identify the transition from commensal to pathogenic. Discussion Immune suppression, altered skin lipids, and environmental changes can trigger dysbiosis and fungal overgrowth, yet the timing and progression of its pathogenic switch remain poorly defined. Conclusion Longitudinal studies are needed to clarify the timing and mechanisms of disease progression and guide prevention and treatment strategies.