Cutaneous manifestations of disseminated cryptococcosis

Disseminated cryptococcosis is a life-threatening infection with cutaneous dissemination in 10% to 20% of cases. We describe seven patients with disseminated cryptococcosis with variable cutaneous manifestations. AIDS was a predisposing factor in six patients. Cutaneous presentations included a draining sinus tract, verrucous nodules, molluscum-like lesions and erythematous, indurated plaques. Histologically, all lesions revealed numerous encapsulated cryptoccocal organisms in a gelatinous pattern, highlighted with periodic acid-Schiff, mucicarmine, and methenamine silver stains. The patients responded variably to treatment with amphotericin B, flucytosine, and fluconazole.