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A Case of Primary Cutaneous Cryptococcosis in a Patient with Iatrogenic Cushing's Syndrome

Do Hyun Kim,Min Kim,Seong Jin Kim,Seung Chul Lee,Young Ho Won
Epub 2016 February 24

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Abstract



We presented here a case of the primary cutaneous cryptococcosis in a patient with iatrogenic Cushing's syndrome. The patient was 72-year-old female and showed painful shallow ulcer with pus discharge on the left forearm. She had been receiving systemic corticosteroids without doctor's prescription for 20 years. Laboratory findings revealed impaired cell mediated immunity, decreased serum and urine cortisol, and ACTH. A biopsy specimen showed granulomatous reaction consisting of lymphohistiocytes, multinucleated giant cell, and many spores with thick capsules. A tissue and pus culture of the lesion on Sabouraud's media at 37℃ showed moist smooth, mucoid creamy colored colonies 3 days later and revealed encapsulated yeast cells in the India ink preparations. The patient was successfully treated with oral itaconazole and fluconazole without side effects.

Keywords


Iatrogenic Cushing's syndrome Itaconazole Primary cutaneous cryptococcosis




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