Cutaneous ulcer in an immunosuppressed patient with adult onset Still's disease: primary cutaneous histoplasmosis?

Abstract

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.

Primary cutaneous histoplasmosis in an immunocompromised patient with long-standing rheumatoid arthritis

“…There were only a few descriptions of PCH in patients with autoimmune rheumatic diseases such as the current case. 5 As previously reported, 3 the use of itraconazole as therapy of choice yielded complete response.…”

“…3 Primary cutaneous histoplasmosis is a rare form of presentation initially described in 1947, 4 with only 23 cases reported in the literature to date. 5 We report the case of an immunocompromised patient with rheumatoid arthritis (RA) who developed, unexpectedly, primary cutaneous histoplasmosis (PCH).…”