Necrotic skin lesions associated with disseminated candidiasis

A 69-year-old woman with Felty's syndrome developed necrotic skin lesions associated with disseminated Candida tropicalis infection. These lesions differed from the previously described erythematous macronodules of disseminated candidiasis, although histologically there was a dermal infiltrate of yeast and pseudohyphae. Clinically, they resembled ecthyma gangrenosum associated with Pseudomonas septicemia. We believe candidiasis should be included in the differential diagnosis of large necrotic skin lesions in the compromised host.