Korean Journal of Medical Mycology  1998;3(2):195-199

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

Do Hyun KIM 1 ; Min KIM ; Seong Jin KIM ; Seung Chul LEE ; Young Ho WON

Affiliations

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Keywords

Primary cutaneous cryptococcosis; Iatrogenic Cushing's syndrome; Itaconazole

Country

Republic of Korea

Language

Korean

MeSH

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 degrees C 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.