CUTANEOUS MANIFESTATIONS OF FUNGAL INFECTION

Fungal infection of the skin and subcutaneous tissue may result from e ither direct contact or inoculation injury (primary infection) or from hematogenous spread from a primary focus of disease (secondary infect ion). The parainfectious lesions of erythema nodosum and erythema mult iforme are manifestations of the host's immune response to the invadin g fungus, particularly Histoplasma capsulatum and Coccidiodes immitis. In some patients, skin lesions may be the only sign of a systemic fun gal infection, and prompt recognition of these lesions may facilitate early diagnosis and treatment. This article first addresses the pathog enesis, host defenses, and diagnosis of fungal skin infections. The sp ecific cutaneous manifestations of the superficial, cutaneous, subcuta neous, and systemic mycoses are then reviewed.