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Cutaneous cryptococcosis successfully treated with itraconazole

¹National Skin Centre, Singapore.

|May 1, 1993

Summary

Primary cutaneous cryptococcosis in an immunocompromised patient was effectively treated with oral itraconazole. A six-month course of this antifungal medication led to complete clearance of the infection without adverse effects.

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Area of Science:

Mycology
Dermatology
Infectious Diseases

Background:

Primary cutaneous cryptococcosis is a rare fungal infection, often occurring after direct inoculation.
Immunosuppression, particularly from long-term systemic steroid use for conditions like chronic obstructive airway disease, increases susceptibility.
Cutaneous manifestations can present as verrucous plaques with abscess formation.

Observation:

A 70-year-old male laborer presented with a large, verrucous plaque and abscess on his forearm, indicative of primary cutaneous cryptococcosis.
The patient had a history of chronic obstructive airway disease and was on long-term systemic steroid therapy, suggesting iatrogenic immunosuppression.
The infection was likely acquired through direct inoculation from trauma.

Findings:

Successful treatment of primary cutaneous cryptococcosis was achieved using oral itraconazole.
A daily dosage of 200 mg of oral itraconazole for six months resulted in complete resolution of the fungal infection.
The patient tolerated the treatment well, experiencing no adverse side effects during the six-month course.

Implications:

Oral itraconazole is a viable and safe therapeutic option for primary cutaneous cryptococcosis, especially in immunocompromised patients.
This case highlights the importance of considering fungal infections in patients with unexplained skin lesions and risk factors for immunosuppression.
Further research into antifungal treatment protocols for cutaneous mycoses is warranted.

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