Primary Cutaneous Cryptococcosis: Review and Morphologic Study

Abstract

Five cases of cryptococcosis, including the one reported here, appear to fit in the category of primary infection of skin; however, infection by cutaneous inoculation was not proven in these patients. In our case serologic studies showed that eventually the disease became disseminated. We have found no convincing report of cryptococcosis that has remained localized to the skin. Patients who appear to have localized cryptococcosis should be repeatedly tested by latex agglutination of serum and spinal fluid for cryptococcal antigens. The topical use of amphotericin B may not be indicated if all cases are considered to be actually or potentially disseminated. In our patient, topical amphotericin B failed to modify the cutaneous lesion. The ultrastructure of cryptococcosis is described in our patient.