Korean J Med Mycol.  1998 Dec;3(2):195-199.

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

• Kim DH
• Kim M
• Kim SJ
• Lee SC
• Won YH

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.

Keyword

Primary cutaneous cryptococcosis; Iatrogenic Cushing's syndrome; Itaconazole

MeSH Terms

Adrenal Cortex Hormones
Adrenocorticotropic Hormone
Aged
Biopsy
Capsules
Cryptococcosis*
Cushing Syndrome*
Female
Fluconazole
Forearm
Giant Cells
Humans
Hydrocortisone
Immunity, Cellular
India
Ink
Prescriptions
Spores
Suppuration
Ulcer
Yeasts
Adrenal Cortex Hormones
Adrenocorticotropic Hormone
Capsules
Fluconazole
Hydrocortisone