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Definition Return to top
Skin lesions of coccidioidomycosis are a manifestation in the skin of a fungal infection caused by Cocciodioides inmitis.Causes, incidence, and risk factors Return to top
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 inhaling fungal particles from soil in these regions. The portal 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 or 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 Return to top
Signs and tests Return to top
The diagnosis depends on the stage of infection (primary versus disseminated) and may include skin biopsy to detect the fungus in culture if disseminated disease is suspected.Treatment Return to top
The mainstay of treatment includes antifungal medications. Depending on the form or stage of disease, intravenous or oral preparations may be used. Antifungal agents commonly used include amphotericin B, itraconazole, ketoconazole, or fluconazole. People with disseminated disease and underlying immunosuppression may require long-term treatment.Expectations (prognosis) Return to top
The outcome varies with the stage and extent of infection, as well as the underlying immune system status of the individual. Disseminated disease has the highest mortality rate, particularly in immunosuppressed individuals.Complications Return to top
Calling your health care provider Return to top
There are many types of skin lesions, and they can be hard to tell apart. Notify your medical provider if you develop skin lesions and suspect this condition, as you will need to be formally evaluated. Update Date: 7/16/2004 Updated by: Daniel Levy, M.D., Ph.D., Infectious Diseases, Greater Baltimore Medical Center, Baltimore, MD. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |