Disseminated Histoplasmosis Presenting as an Ulcerated Verrucous Plaque in a Human Immunodeficiency Virus‐Infected Man

Abstract

A 46-year-old homosexual man with disseminated histoplasmosis and human immunodeficiency virus (HIV) infection had a histoplasmosis-related ulcerated verrucous plaque above his left upper lip; systemic and cutaneous disease manifestations of histoplasmosis resolved with daily ketoconazole therapy. Disseminated histoplasmosis, with similar cutaneous features, also was present in his HIV-seropositive male sexual partner. The possibility of human-to-human transmission of histoplasmosis between these patients is considered and the skin lesions of systemic fungal infections in HIV-infected patients are reviewed.

Disseminated cutaneous histoplasmosis in acquired immunodeficiency syndrome: report of 23 cases

“…15 In our study, all the patients presented with papules, nodules and crusting plaques, and some presented with ulcers and purpuric lesions. The literature mentions that the most affected sites are the face, limbs, and trunk, similar to the findings in our study 3,7,18,21,22 (Figs 1-3). The major differential diagnoses that should be considered are cryptococcosis and penicillosis.…”

Acquired immunodeficiency syndrome‐related oral and/or cutaneous histoplasmosis: a descriptive and comparative study of 21 cases in French Guiana

“…A comprehensive retrospective study of AIDS‐related DH cases, mycologically confirmed by Giemsa smears and/or culture and/or pathology, was performed in French Guiana between 1981 and 1998. Tissue smears were taken under local anesthesia and subjected to Giemsa staining, making it possible to detect histoplasmas within minutes 6–8 . Demographic (age, sex, geographic origin, mode of human immunodeficiency virus (HIV) contamination), clinical, biologic (CD4 counts), microbiologic, therapeutic, and follow‐up data were obtained from medical files.…”

“…Tissue smears were taken under local anesthesia and subjected to Giemsa staining, making it possible to detect histoplasmas within minutes. 6…”

Skin Diseases Associated with HIV Infection

“…Other morphologies include pustules, abscesses, nodules, umbilicated papules, ulcers and erythematous scaly plaques. Maculopapular exanthema, vegetative lesions, oral ulcers, and perianal ulcers are also observed [73]. Histological features range from tuberculoid granulomas with areas of necrosis, to accumulation of macrophages containing abundant organisms with a surrounding clear halo, to Histoplasma free in the dermis with little associated inflammation.…”