Cutaneous manifestations of disseminated candidiasis

Recognition of the characteristic cutaneous lesions of disseminated candidiasis may allow earlier diagnosis and treatment of this often fatal fungal infection. The skin lesion developed in patients with hematologic malignancies and compromised host defenses, at a time when they were febrile, clinically deteriorating, and failing to respond to multiple antibiotics. This report discusses two patients with acute myelogenous leukemia with cutaneous manifestations of disseminated candidiasis due to Candida tropicalis. Single or multiple erythematous or purpuric 0.5- to 1-cm papulonodules with pale centers were seen on the trunk and proximal extremities. In most reported cases of disseminated candidiasis with skin lesions, the diagnosis can be confirmed by histologic evaluation of a skin biopsy before appropriate cultures identify the organism.