title: Subcorneal pustular dermatosis associated with Coccidioides immitis.
abstract: Coccidioidomycosis (AKA "Valley fever") is a primary pulmonary infection via airborne spores released from coccidioides immitis in the soil. Reactive cutaneous eruptions resulting from the pulmonary infection are difficult to diagnose because skin biopsies do not contain the organism. We present an adolescent male with primary pulmonary C.immitis infection manifesting with biopsy proven subcorneal pustular dermatosis. Serological studies revealed increasingly positive titers for coccidioidomycosis and symptoms resolved promptly following initiation of systemic antifungal therapy. Our unique case presentation illustrates subcorneal pustular dermatosis as a reactive eruption owing to primary pulmonary coccidioidomycosis. An association between the two conditions warrants further investigation.
authors.forename: Sanjana
authors.initials: S
authors.lastname: Iyengar
authors.forename: Cindy J
authors.initials: CJ
authors.lastname: Chambers
authors.forename: Shurong
authors.initials: S
authors.lastname: Chang
authors.forename: Maxwell A
authors.initials: MA
authors.lastname: Fung
authors.affiliation: University of California, Davis. vrs2001@gmail.com.
authors.forename: Victoria R
authors.initials: VR
authors.lastname: Sharon
mesh_terms: D000293:Adolescent; D000935:Antifungal Agents / Q000627:therapeutic use; D001416:Back Pain / Q000209:etiology; D002140:California; D003045:Coccidioides / Q000302:isolation & purification*; D003047:Coccidioidomycosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D057210:Delayed Diagnosis; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis; D003951:Diagnostic Errors; D019353:Endemic Diseases; D005189:False Positive Reactions; D005221:Fatigue / Q000209:etiology; D005334:Fever / Q000209:etiology; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D012373:Rocky Mountain Spotted Fever / Q000175:diagnosis; D012536:Scalp Dermatoses / Q000209:etiology / Q000382:microbiology; D012872:Skin Diseases, Vesiculobullous / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole