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Primary cutaneous cryptococcosis in immunocompetent and immunocompromised hosts.
John C Christianson1, William Engber, David Andes
1Department of Medicine, Division of Infectious Diseases, University of Wisconsin Hospital and Clinics, Madison, Wisconsin 53792-5158, USA.
Medical Mycology
|September 11, 2003
Summary
Primary cutaneous cryptococcosis, a fungal skin infection, can arise from local inoculation or spread. Antifungal therapy is recommended for all localized cases due to unpredictable outcomes without treatment.
Area of Science:
- Mycology
- Dermatology
- Infectious Diseases
Background:
- Primary cutaneous cryptococcosis is a rare fungal infection.
- It can affect both immunocompetent and immunocompromised individuals.
- Risk factors include conditions impairing cell-mediated immunity.
Observation:
- Cutaneous manifestations are diverse and can mimic other skin conditions.
- Infection can result from direct inoculation or systemic dissemination.
- Risk factors include corticosteroid use, organ transplantation, sarcoidosis, and immunosuppression.
Findings:
- Patients diagnosed with skin cryptococcosis require evaluation for disseminated disease.
- Assessment of cell-mediated immunity is crucial.
- Predicting which patients will resolve without antifungal therapy is not possible.
Implications:
- Antifungal therapy is advised for all patients with localized cutaneous cryptococcosis.
- Treatment decisions depend on disease extent and host immune status.
- Early diagnosis and comprehensive evaluation are essential for effective management.