Primary cutaneous cryptococcosis as the presenting manifestation of AIDS

Presented is a case of primary cutaneous cryptococcosis, presenting as a papular facial lesion with subsequent ulceration, as the initial manifestation of AIDS. This unusual condition must be considered in the workup of unexplained or therapeutically unresponsive skin lesions. If it is diagnosed in an ostensibly "healthy" individual, evaluation for evidence of immunosuppression, and its underlying cause, must be undertaken.