Coccidioidomycosis: a review and update.

Area of Science:

• Medical Mycology
• Dermatology
• Infectious Diseases

Background:

• Coccidioidomycosis is endemic in arid/semi-arid regions of the New World, particularly the southwestern United States.
• Caused by Coccidioides species in soil, infection occurs via airborne arthroconidia, primarily affecting the lungs.
• Cutaneous involvement can result from direct dissemination or reactive processes.

Purpose of the Study:

• To highlight the diverse cutaneous manifestations of Coccidioidomycosis.
• To emphasize the diagnostic importance of skin findings in this fungal infection.
• To increase awareness of recently recognized reactive skin signs.

Main Methods:

• Review of clinical presentations and literature on Coccidioidomycosis.
• Analysis of reported cases with cutaneous involvement.
• Identification of characteristic and emerging dermatologic signs.

Main Results:

• Coccidioidomycosis presents with varied skin manifestations, including dissemination and reactive eruptions like erythema nodosum.
• Recently identified reactive signs include interstitial granulomatous dermatitis and Sweet's syndrome.
• Cutaneous findings serve as vital diagnostic clues for this pulmonary fungal infection.

Conclusions:

• Coccidioidomycosis is a complex disease with protean manifestations, often mimicking other conditions.
• Dermatologists play a key role in identifying Coccidioidomycosis through recognition of its varied skin signs.
• Early diagnosis facilitated by cutaneous clues can improve patient outcomes for this significant fungal disease.