Primary cutaneous cryptococcosis is isolated cutaneous cryptococcosis without evidence of systemic involvement. It usually presents as a solitary nodule in an exposed area, such as head and neck or extremities, and the occurrence of primary cutaneous cryptococcosis in the covered area has been rarely reported in the literature. A healthy 81-year-old immunocompetent woman presented with a solitary reddish scaly plaque on her abdomen without clinical evidence of systemic cryptococcal infection. Histopathologic examination showed numerous encapsulated spores, and the organism was identified as Cryptococcus neoformans in a series of fungal studies. We diagnosed this case as a primary cutaneous cryptococcosis by the findings mentioned above. The patient was successfully treated with surgical excision and oral fluconazole without any side effects.
Abdomen* ; Aged, 80 and over ; Cryptococcosis* ; Cryptococcus neoformans ; Extremities ; Female ; Fluconazole ; Head ; Humans ; Neck ; Spores

Tinea incognito is a dermatophytosis modified by previous treatments such as prolonged use of corticosteroids. Because the lesions often atypical appearing without classic features of ringworm, the diagnosis can be delayed or missed especially when tinea incognito is on the face and neck. A 75-year-old male patient who had been treated with topical steroids at the local dermatologic clinic for 10 years for the eczematous lesion on the scalp and face and recently the lesions spread throughout his neck and back. Physical examination showed ill-defined erythematous scaly patches on the face, neck and back and reddish crusted papules on the scalp. Potassium hydroxide (KOH) preparation on the left face and right neck showed hyphae and fungus cultures were positive for colonies of Trichophyton rubrum (T. ruburum). The result of DNA sequencing from the colony was identical to that of T. rubrum. The lesions were treated by oral terbinafine and topical isoconazole.
Adrenal Cortex Hormones ; Aged ; Diagnosis ; Fungi ; Humans ; Hyphae ; Male ; Neck* ; Physical Examination ; Potassium ; Scalp ; Sequence Analysis, DNA ; Steroids ; Tinea* ; Trichophyton