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Skin lesion of coccidioidomycosis

Skin lesion of coccidioidomycosis

Erythema nodosum on the foot
Erythema nodosum on the foot

Definition:

Skin lesions of coccidioidomycosis are skin symptoms of a fungal infection caused by Coccidioides immitis.

Causes, incidence, and risk factors:

Coccidioidomycosis is a fungal infection most often found in the desert regions of the southwestern US, and in Central and South America. It is acquired by breathing in fungal particles from soil in these regions. The point of entry for this infection is the lung.

Up to one-half of affected individuals have mild or no symptoms. Immunosuppressed individuals, such as people with AIDS, cancer, or transplant recipients, are at higher risk of severe, widespread (disseminated) disease.

Skin lesions can occur in the early stages of coccidioidomycosis (during primary lung infection). They include erythema nodosum or erythema multiforme. These rashes usually clear without treatment and are believed to be caused by an immune response to the infection.

After primary infection in the lungs, the fungus itself may spread to other tissues including the skin, and lead to various skin lesions including papules, nodules, and ulcers. These lesions contain fungus within them and are a manifestation of disseminated (widespread) fungal disease.

Symptoms:
  • Skin lesion of primary infection
    • Papular rash
    • Erythema nodosum
    • Erythema multiforme (target lesions)
  • Skin lesion of disseminated disease: papule, pustule, nodule, or plaque
    • May ulcerate
    • Most frequently found on the face
    • May form abscesses
Signs and tests:

The diagnosis depends on the stage of infection (primary versus disseminated). Diagnosis may include skin biopsy to find the fungus in a culture if disseminated disease is suspected.


Review Date: 9/5/2006
Reviewed By: D. Scott Smith, M.D., MSc, DTM&H, Chief of Infectious Disease & Geographic Medicine, Kaiser Redwood City, CA & Adjunct Assistant Professor, Stanford University. Review provided by VeriMed Healthcare Network.

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