title: Disseminated cellulitic cryptococcosis in the setting of prednisone monotherapy for pemphigus vulgaris.
abstract: Cryptococcal infections are seen mainly in immunocompromised hosts. The cutaneous manifestations of infection can include papules, plaques, nodules, vesicles, ulcers, ecchymosis, and, rarely, cellulitis. Cryptococcal meningitis is a life-threatening complication of this disease. Pemphigus vulgaris is a rare auto-immune blistering disease that can also be life-threatening. Treatment of pemphigus commonly entails both corticosteroids and steroid-sparing agents. We present a case of disseminated cryptococcal infection in a patient with pemphigus vulgaris treated with high dose corticosteroids as monotherapy. This case provides an opportunity to discuss the difficulty of managing two potentially mortal conditions in which the treatment of pemphigus vulgaris may exacerbate the disseminated cryptococcal infection.
authors.affiliation: Department of Dermatology, Johns Hopkins Medical Institutes, Baltimore, Maryland 21287, USA.
authors.forename: Simon S
authors.initials: SS
authors.lastname: Yoo
authors.forename: Mark
authors.initials: M
authors.lastname: Tran
authors.forename: Grant
authors.initials: G
authors.lastname: Anhalt
authors.forename: Terry
authors.initials: T
authors.lastname: Barrett
authors.forename: Eric C
authors.initials: EC
authors.lastname: Vonderheid
mesh_terms: D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002481:Cellulitis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D003453:Cryptococcosis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D003924:Diabetes Mellitus, Type 2; D003937:Diagnosis, Differential; D004334:Drug Administration Schedule; D015725:Fluconazole / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D007871:Leg Ulcer / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole; D011241:Prednisone