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Cutaneous cryptococcosis

Last edited: 4/10/2026

Overview

Cutaneous cryptococcosis is a fungal infection of the skin caused by Cryptococcus species. It can occur as a primary infection or, more commonly, as a manifestation of disseminated cryptococcosis, particularly in immunocompromised individuals 1.

Diagnosis

  • Diagnosis is typically made by direct microscopic examination of clinical specimens (e.g., skin biopsy, aspirate) with India ink staining to visualize encapsulated yeast forms 1.
  • Fungal culture from skin lesions or other relevant sites is essential for species identification and antifungal susceptibility testing 1.
  • Histopathological examination of skin biopsies can reveal characteristic granulomatous inflammation and yeast cells 1.
  • Management

  • Treatment depends on the extent of disease and the patient's immune status. For localized cutaneous disease in immunocompetent hosts, oral fluconazole may be considered 1.
  • For disseminated disease or in immunocompromised patients, combination therapy with amphotericin B (often deoxycholate or lipid formulations) followed by a step-down to fluconazole or other azoles is typically recommended 1.
  • Surgical excision of localized lesions may be considered in select cases 1.
  • Special Populations

  • Patients with underlying conditions such as non-Hodgkin's lymphoma are at increased risk for severe or disseminated cutaneous cryptococcosis 1.
  • Key Recommendations

  • Diagnosis of cutaneous cryptococcosis should be confirmed by direct microscopy and fungal culture of skin lesions 1. (Evidence: Moderate)
  • Disseminated cryptococcosis, including cutaneous involvement, in immunocompromised patients typically requires treatment with amphotericin B followed by an azole 1. (Evidence: Moderate)
  • Consider surgical excision for localized cutaneous lesions, especially in immunocompetent individuals 1. (Evidence: Expert opinion)
  • References

    1 Yu RY. Cutaneous cryptococcosis. Mycoses 1996. link

    Original source

    1. [1]
      Cutaneous cryptococcosis.Yu RY Mycoses (1996)

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