Ulcer as the only manifestation of disseminated cryptococcosis in a patient with rheumatoid arthritis
DOI:
https://doi.org/10.47196/da.v31i2.2875Keywords:
extrapulmonary cryptococcosis, cutaneous cryptoccocosis, non HIV immunosuppressionAbstract
Cryptococcosis is a systemic mycosis caused by yeasts of the genus Cryptococcus. Extrapulmonary forms are frequently observed in patients with immunodeficiencies. Skin lesions are characterized by clinical polymorphism, presenting molluscoid papules, pustules, subcutaneous abscesses, nodules and acneiform lesions. Ulcer as a clinical manifestation is rare. Diagnosis is established through direct visualization of the fungus and cultures. The first-line treatment is amphotericin B and in mild forms fluconazole may be indicated. We present the exceptional case of a patient with rheumatoid arthritis being treated with glucocorticoid, methotrexate and leflunamide who presented an ulcer as the only manifestation of disseminated cryptococcosis.
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