title: Primary cutaneous Cryptococcosis during therapy with methotrexate and adalimumab.
abstract: Primary cutaneous infection with Cryptococcus neoformans is uncommon, but can occur following an inoculation injury to the skin. Tumor necrosis factor-alpha (TNF-alpha) is important in the immune response to Cryptococcus, and patients taking inhibitors of TNF-alpha may have increased susceptibility to cryptococcal infection. We report a case of primary cutaneous cryptococcosis in a patient taking adalimumab, methotrexate, and hydroxychloroquine for rheumatoid arthritis.
authors.affiliation: Geisinger Medical Center, Department of Dermatology, Danville, PA 17822, USA. mlwilson@geisinger.edu
authors.forename: Morgan L
authors.initials: ML
authors.lastname: Wilson
authors.forename: Lindsay D
authors.initials: LD
authors.lastname: Sewell
authors.forename: Christen M
authors.initials: CM
authors.lastname: Mowad
mesh_terms: D000068879:Adalimumab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000935:Antifungal Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy; D003453:Cryptococcosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003455:Cryptococcus neoformans / Q000187:drug effects / Q000254:growth & development / Q000302:isolation & purification; D003881:Dermatomycoses / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005383:Finger Injuries / Q000150:complications / Q000175:diagnosis / Q000382:microbiology; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000935:Antifungal Agents; D018501:Antirheumatic Agents; D006886:Hydroxychloroquine; D015725:Fluconazole; D000068879:Adalimumab; D008727:Methotrexate