Primary cutaneous cryptococcosis in an immunocompetent man: A case report

Abstract

Cutaneous cryptococcosis usually develops secondary to hematogenous spread in immunocompromised hosts. Primary cutaneous cryptococcosis (PCC) is a rare condition characterized by localized skin eruptions and positive culture for Cryptococcus neoformans but without dissemination to the internal organs. Herein, we describe a typical case of PCC in an immunocompetent male who presented with a 1-month history of scattered erythematous indurated papules and plaques on his arm and without fever. The histology of his skin, tissue culture, and multiplex polymerase chain reaction (PCR) confirmed cutaneous cryptococcal infection by C neoformans var. neoformans. After extensive work-ups showed no evidence of systemic dissemination or underlying cellular-immunity deficiency, the diagnosis of primary cutaneous cryptococcosis was made. Treatment with fluconazole 400 mg daily for 14 days followed by 200 mg daily for another 14 days led to complete resolution of the skin lesions, and subsequent follow-up showed no signs of relapse.