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Cutaneous cryptococcosis simulating pyoderma gangrenosum

M C Massa, J A Doyle

    Journal of the American Academy of Dermatology
    |July 1, 1981
    PubMed
    Summary
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    This case highlights a rare instance where Cryptococcus neoformans caused skin ulcers, initially mimicking pyoderma gangrenosum in an ulcerative colitis patient. Fungal infection should be ruled out in suspected pyoderma gangrenosum cases.

    Area of Science:

    • Dermatology
    • Infectious Diseases
    • Mycology

    Background:

    • Chronic ulcerative colitis (CUC) is an inflammatory bowel disease.
    • Pyoderma gangrenosum (PG) is a rare, ulcerative skin condition often associated with systemic diseases like CUC.
    • Cutaneous manifestations in CUC patients can be diverse.

    Observation:

    • A 33-year-old male with a history of CUC presented with multiple skin ulcers and an indurated area on his thigh.
    • The clinical presentation was initially suspected to be pyoderma gangrenosum.
    • Tissue biopsy revealed numerous yeast forms identified as Cryptococcus neoformans.

    Findings:

    • Cryptococcus neoformans was identified in tissue biopsies from the patient's cutaneous ulcers.
    • A previously indurated area on the thigh subsequently ulcerated and also tested positive for Cryptococcus.

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  • This indicated a deep fungal infection mimicking pyoderma gangrenosum.

    • Implications:

    • The case underscores the importance of considering deep fungal infections in the differential diagnosis of pyoderma gangrenosum.
    • Appropriate diagnostic studies, including fungal cultures and microscopy, are crucial for accurate diagnosis.
    • Early identification and treatment of fungal infections can prevent misdiagnosis and ensure effective management in immunocompromised or susceptible patients.