CUTANEOUS MANIFESTATIONS OF SYSTEMIC MYCOSES

Systemic fungal diseases are primary pulmonary diseases caused by the dimorphic fungal pathogens, Blastomyces dermatitides, Coccidioides imm itis, Histoplasma capsulatum, or Paracoccidioides brasiliensis. Infect ion occurs after inhalation of the infectious form of the fungus and m ay be acute, self-limited, or subclinical. Primary cutaneous infection occurs only after traumatic implantation of the fungus and is unusual . Erythema nodosum or erythema multiforme may accompany the acute form of the disease. Other cutaneous manifestations represent disseminated disease and, as such, require systemic antifungal therapy. Because cu taneous lesions have occurred coincidentally with other cutaneous path ologies, emphasis should be placed on a complete clinical history, phy sical examination, and diagnosis by histopathology and culture.