Proteus syndrome is a rare syndrome characterized by disproportionate overgrowth
of limbs, multiple hamartomas, and vascular malformations. The cerebriform
connective tissue nevi, also called cerebriform plantar hyperplasia, are present
in most patients, and is the main characteristic of the syndrome. If present,
even alone, they can be considered as a pathognomonic sign. This article reports
a classic case of Proteus syndrome in a 2-year-old male patient who began to
show a discrete asymmetry of the right hemibody in relation to the left one
after birth, which increased over the months. He also showed cerebriform plantar
hyperplasia and Port-wine stains, among other alterations.
Cryptococcosis is a fungal infection caused by Cryptococcus
neoformans that tends to affect immunocompromised individuals. The
fungi are mostly acquired by inhalation, which leads to an initial pulmonary
infection. Later, other organs - such as the central nervous system and the skin
- can be affected by hematogenous spread. In addition, cutaneous contamination
can occur by primary inoculation after injuries (primary cutaneous
cryptococcosis), whose diagnosis is defined based on the absence of systemic
involvement. The clinical presentation of cutaneous forms typically vary
according to the infection mode. We report an unusual case of disseminated
cryptococcosis in an immunocompetent patient with cutaneous lesions similar to
those caused by primary inoculation. This clinical picture leads us to question
the definition of primary cutaneous cryptococcosis established in the
literature.
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