Malassezia has seven different subspecies that cause or contribute to a spectrum of conditions, with M. symbodialis, M. globosa and M. furfur the most common species isolated. These are commensal organisms on normal skin, however show greater diversity and immunoreactivity in patients with HIV leading to greater likelihood of associated cutaneous manifestations. (95)
Clinical presentation
Malassezia can present in the setting of HIV as pruritic pustules, plaques or papules on the face, chest, back and shoulders. Due to its morphology and distribution, Malassezia pustules may be confused with acne vulgaris however comedones are not present as with acne.