Progressive Disseminated Histoplasmosis and HIV/AIDS: a Dermatological Perspective

Abstract Progressive disseminated histoplasmosis (PDH) occurs as a result of internal spread of Histoplasma capsulatum from the lungs to organs rich in monocytes. This typically occurs in immunosuppressed patients, such as those with HIV/AIDS. Skin involvement is found in 10 % of all patients with PDH in the USA and in up to 25 % of those with AIDS. Crusted papular or plaque-like lesions are most common, with others being nodular, pustular, ulcerated, vegetative, acneiform, or wart-like. Lesions may be caused by the fungus itself or an immune response to the infection, such as erythema nodosum or erythema multiform. Histopathology demonstrates necrosis of the superficial dermal vessels. The differential diagnosis is broad and varies depending on the location and morphology of the lesion(s). Culture is the gold standard for diagnosis, and first-line treatment is amphotericin B for 1–2 weeks at a dose of 3 mg/kg/day.

http://link.springer.com/10.1007/s12281-015-0233-2

Source: Current Fungal Infection Reports - October 3, 2015 Category: Infectious Diseases Source Type: research