Polymorphic Skin Ulcers as Initial Manifestation of a System | 90056

Plastic Surgery: Case Studies


Polymorphic Skin Ulcers as Initial Manifestation of a Systemic Cryptococosis

Natalia Coras*, Edward Alca and Víctor Delgado

91-years-old male, with a history of atopic dermatitis and cerebrovascular disorder without sequelae. 7 months ago, he presented an erythematous plaque on the posterior chest, itching, with partial improvement for treatment. 2 months ago, the lesion increased in size with ulceration. He also presented other ulcers in the facial region, receiving antibiotic treatment with slight improvement. 1 month ago, new multiple ulcers were associated with a predominance of the scalp and anterior chest. 1 week ago, he went to the emergency for nasal obstruction and epistaxis. In the histopathological study of the skin, chronic granulomatous nodular dermatitis was evidenced. Stains were made with Schiff's periodic acid and Gomori-Grocott silver methenamine observing the presence of spherical structures compatible with Cryptococco skin sample culture confirms neoforman cryptococco infection. The presentation of this case is the atypical cutaneous manifestation such as multiple ulcers without systemic symptoms as the initial manifestation of disseminated cryptococcosis.