Two cases of cutaneous cryptococcosis.
We report two cases of cutaneous cryptococcosis in male patients without underlying disease. Case 1 had a granulomatous mass on his right neck, gradually enlarging for 3 months. After the mass was debrided surgically in a hospital, the incision wound gradually developed into a severe ulceration. Mycological examination revealed Cryptococcus neoformans infection. It was significant that histopathology of both pre-surgery granuloma and post-surgery ulceration revealed thick-walled spores with thick capsule. Chest X-ray revealed a shadow in the left lower lung. After treatment with amphotec for 21 days, the lesion healed. Case 2 had an approximately 2 x 2 cm solitary dull nodule on his right thigh, which had been present for 8 months. Mycological examination confirmed that the lesion was caused by C. neoformans. The patient's ratio of peripheral blood CD4(+) cell was slightly reduced. After 14 days of treatment with oral fluconazole, followed by oral itraconazole for 2 months, mycological and clinical cure were achieved. The two isolates were identified as C. neoformans var. gattii serotype C and C. neoformans var. grubii serotype A.
Department of Dermatology, 3rd Hospital, Hangzhou, China. xiaxiujiao@hz.cn
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D000328:Adult; D000666:Amphotericin B / Q000494:pharmacology / Q000627:therapeutic use; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use; D003453:Cryptococcosis / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D003455:Cryptococcus neoformans / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D003881:Dermatomycoses / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D015725:Fluconazole / Q000494:pharmacology / Q000627:therapeutic use; D006099:Granuloma / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D006801:Humans; D017964:Itraconazole / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D009333:Neck; D013172:Spores, Fungal; D013848:Thigh
D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B; D015725:Fluconazole