Primary cutaneous cryptococcosis in an immunocompetent host

We report a case of primary cutaneous cryptococcosis in an immunocompetent host. Several nodules, isolated or sometimes joint to form plaques, affected the right arm. The arm was paralytic and hypoplastic, and a history of numerous abrasions picking firewood up preceded the onset of the eruption. Histology on skin biopsy documented a dermal infiltrate constituted of histiocytes, lymphocytes, fibroblasts and rare giant cells. Numerous rounded periodic acid-Schiff (PAS) bodies were also present. Cryptococcus neoformans var. neoformans grew upon culture. Complete blood, biochemical and instrumental examinations resulted in findings within normal range. Treatment with itraconazole 200 mg daily for 4 months led to complete recovery. During a 2-year follow-up, the patient did not present any relapse or dissemination to other organs.