Criptococcosi. Spettro clinico istologico in pazienti immunocompromessi

wo cases of cutaneous cryptococcosis occurring in HIV patients are described. In the first case there were numerous, diffuse, molluscum contagious like papules, nodules, necrotic plaques and ulcers. Chest roentgenogram disclosed nodular images. In the second case, there was only an ulcer on the left minor labium without any systemic involvement. In both cases microscopic examination revealed in the dermis numerous intracellular and extracellular yeast-like mycetes with a granulomatous infiltrate. In addition, in the first case a conspicuous edema was present. Fungal cultures revealed Cryptococcus neoformans. In both cases the treatment with itraconaxole obtained the resolution of the lesions. The first case emphasizes the importance of cutaneous lesions as an early marker of disseminate disease. Primary cryptococcal skin infection is a rare and debated event. Vulvar involvement is unusual and has not previously been described. The problem of distinguishing primary from secondary cutaneous cryptococcosis is reviewed. Usually, in the secondary cryptococcosis the lesions are numerous and the inflammatory infiltrate is gelatinous.