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Area of Science:

  • Mycology
  • Infectious Diseases
  • Dermatology

Background:

  • Coccidioidomycosis is an endemic mycosis in specific regions.
  • Primary cutaneous coccidioidomycosis is a rare but increasingly recognized clinical presentation.
  • Cases often occur in endemic areas or in individuals with travel history to these regions.

Purpose of the Study:

  • To review and synthesize the existing literature on primary cutaneous coccidioidomycosis.
  • To analyze the characteristics, diagnosis, and treatment of this rare condition.
  • To highlight the importance of considering primary cutaneous coccidioidomycosis in differential diagnoses.

Main Methods:

  • Extensive literature search across multiple databases (OLDMEDLINE, PubMed, Cochrane, LILACS, Google Scholar) from 1927 to 2019.
  • Inclusion of 42 observational studies, reviews, and one original case.
  • Analysis of epidemiological, clinical, diagnostic, and treatment data.

Main Results:

  • 82 cases of primary cutaneous coccidioidomycosis were identified.
  • Most cases occurred in endemic areas, with a significant proportion linked to local skin trauma.
  • Tissue culture remains a primary diagnostic method, with PCR gaining relevance.
  • Azoles are the first-line treatment, and the prognosis is generally excellent, even without treatment.

Conclusions:

  • Primary cutaneous coccidioidomycosis shares epidemiological links with other forms of coccidioidomycosis.
  • Local skin trauma is a common preceding factor.
  • It should be considered in the differential diagnosis of unusual skin conditions in relevant populations.
  • Early recognition and appropriate management are important despite the generally favorable prognosis.