Histoplasmosis is caused by the dimorphic fungus Histoplasma capsulatum.Primary
infection occurs through inhalation of spores from the air. Immunocompetent
individuals are usually asymptomatic, but may develop pulmonary disease.
Immunocompromised patients tend to present systemic histoplasmosis with
cutaneous lesions occurring by secondary invasion. In this case report, we
describe a probable primary cutaneous histoplasmosis (PCH) in a patient with
adult onset Still's disease under immunosuppression.
Although good, moderate and excellent interobserver agreement were obtained for erosions and PD, concordance for synovitis and cartilage changes were less impressive in our patients with active RA. Further studies on standardization of scanning technique are necessary to improve musculoskeletal US reproducibility.
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