Primary Cutaneous Coccidioidomycosis

Abstract

Prior to 1937, many authorities believed that systemic coccidioidomycosis resulted from direct inoculation of the fungus into the skin, because the skin was frequently the site of the initial lesion and the development of the lesion was often associated with trauma. In that year Dickson^*and later Dickson and Gifford † demonstrated that coccidioidomycosis usually occurs as a benign and self-limited pulmonary infection. It is commonly accepted today that the lung is the usual portal of entry for the Coccidioides immitis and that invasion through the skin is rare. Recently there has been an increased interest in primary cutaneous coccidioidomycosis.‡ Wilson, Smith, and Plunkett⁷described the case of a mortician who accidently inoculated himself while embalming a patient who had died of a disseminated infection. In addition, they enumerated and discussed the criteria for making such a diagnosis. They found that only one