Primary cutaneous histoplasmosis simulating Molluscum contagiosum

Area of Science:

• Mycology
• Dermatology
• Infectious Diseases

Background:

• Primary cutaneous histoplasmosis is an extremely rare manifestation of Histoplasma capsulatum infection.
• Isolated skin involvement without systemic dissemination is exceptionally uncommon, with few documented cases globally.
• Human Immunodeficiency Virus (HIV) positivity is a significant risk factor for disseminated fungal infections.

Observation:

• A Human Immunodeficiency Virus (HIV)-positive patient presented with a distinctive cutaneous lesion.
• The lesion clinically mimicked Molluscum contagiosum.
• Histopathological examination confirmed the presence of Histoplasma capsulatum within the skin lesions.

Findings:

• The patient exhibited isolated cutaneous involvement, with no evidence of deeper organ or systemic disease.
• Treatment with Itraconazole led to a rapid and complete resolution of the cutaneous lesions.
• Initiation of Highly Active Antiretroviral Therapy (HAART) was part of the patient's management.

Implications:

• This case underscores the importance of considering rare fungal infections in the differential diagnosis of skin lesions in immunocompromised patients.
• Prompt diagnosis and targeted antifungal therapy, such as Itraconazole, can effectively manage primary cutaneous histoplasmosis.
• The successful outcome emphasizes the critical role of HAART in managing HIV-associated opportunistic infections.