Funding sources: none.
Primary cutaneous cryptococcosis in Brazil: report of 11 cases in immunocompetent and immunosuppressed patients
Article first published online: 20 JUN 2012
© 2012 The International Society of Dermatology
International Journal of Dermatology
Volume 51, Issue 7, pages 780–784, July 2012
How to Cite
Marques, S. A., Bastazini, I., Martins, A. L. G. P., Barreto, J. A., Barbieri D’Elia, M. P., Lastória, J. C. and Marques, M. E. A. (2012), Primary cutaneous cryptococcosis in Brazil: report of 11 cases in immunocompetent and immunosuppressed patients. International Journal of Dermatology, 51: 780–784. doi: 10.1111/j.1365-4632.2011.05298.x
Conflicts of interest: none.
- Issue published online: 20 JUN 2012
- Article first published online: 20 JUN 2012
Background Primary cutaneous cryptococcosis is an uncommon infectious disease caused by Cryptococcus neoformans or Cryptococcus gattii affecting immunosuppressed as well as immunocompetent patients. It is often misdiagnosed as it may mimic other cutaneous diseases.
Materials and methods We report a series of cases diagnosed from 2005 to 2010 in two general hospitals. The diagnosis in all patients was made on the basis of histopathology and culture. Phenoloxidase and canavanine-glycine-bromothymol blue tests were used in order to identify the Cryptococcus species. Systematic investigation ruled out the systemic involvement in every case.
Results Eleven patients, 81.8% male, were diagnosed during this study. The immunosuppression status was identified in 54.5% of patients, and all of them were under corticosteroid therapy due to a variable set of diseases. All patients presented with circumscribed lesions on their upper limbs. Most lesions showed an infiltrative or tumoral aspect with up to 40 cm diameter. Fluconazole, up to 400 mg/daily, was the main therapeutic regimen and proved to be efficient.
Conclusions Primary cutaneous cryptococcosis has been diagnosed in both immunosuppressed and immunocompetent patients. Its peculiar clinical aspect could facilitate early diagnosis. Culture and biochemical tests should be performed in order to define the species involved.