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Histoplasmosis clinically imitating cutaneous malignancy.

Nicholas Golda¹, Mary Feldman

¹Department of Dermatology, University of Missouri Columbia, Columbia, MO 65212, USA. goldan@health.missouri.edu

Journal of Cutaneous Pathology

|June 12, 2008

Summary

Disseminated histoplasmosis rarely mimics skin cancer. This case highlights a unique presentation of fungal infection, emphasizing the need for biopsy confirmation of cutaneous lesions before treatment.

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Area of Science:

Mycology
Dermatology
Pathology

Background:

Disseminated histoplasmosis presents with diverse cutaneous manifestations.
Cutaneous neoplasms are common differential diagnoses for skin lesions.

Observation:

An 86-year-old male presented with a solitary skin lesion suspicious for malignancy.
Histopathologic analysis revealed a nodule with epidermal erosion and a dense dermal inflammatory infiltrate.
Intracellular fungal spores consistent with Histoplasma were identified within histiocytes.

Findings:

The cutaneous lesion was diagnosed as disseminated histoplasmosis, mimicking a skin neoplasm.
Periodic acid-Schiff (PAS) stain highlighted the characteristic intracellular fungal spores.
This represents an uncommon initial clinical manifestation of disseminated histoplasmosis.

Implications:

Histopathologic examination is crucial for accurate diagnosis of atypical cutaneous lesions.
This case underscores the importance of considering fungal infections in the differential diagnosis of skin neoplasms.
Early and accurate diagnosis prevents unnecessary invasive procedures and guides appropriate antifungal therapy.