Primary cutaneous cryptococcosis in an HIV-negative patient

We report a case of primary cutaneous cryptococcosis in an HIV-negative pat ient, who presented with painless, ulcerated lesions involving the right fo rearm (fingers and elbow), which developed over 45 days. On the basis of th e clinical appearance, serological and cultural examinations were performed to confirm the diagnosis; the histological evaluation of a skin biopsy sho wed an acute inflammatory infiltrate containing several PAS + Cryptococci. Subsequently, the patient was treated with fluconazole (400 mg/day for 10 d ays, then a maintenance therapy of 200 mg/day); after one month, the cutane ous lesions were remarkably improved, but, although a series of further lab oratory and clinical examinations was scheduled, the patient repeatedly ref used any other re-evaluation, and he was lost from follow-up.