Concurrent Primary Cutaneous Cryptococcosis and Bowen's Disease in a Patient With Multiple Sclerosis on Fingolimod: A Rare Case Report and Review of Literature.

Autor:	Gencebay G; Department of Dermatology, Bezmialem Vakif University Faculty of Medicine, Istanbul, TUR., Çetin N; Department of Dermatology, Bezmialem Vakif University Faculty of Medicine, Istanbul, TUR., Gecer M; Department of Pathology, Bezmialem Vakif University Faculty of Medicine, Istanbul, TUR., Su Kucuk O; Department of Dermatology, Bezmialem Vakif University Faculty of Medicine, Istanbul, TUR.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Oct 08; Vol. 16 (10), pp. e71050. Date of Electronic Publication: 2024 Oct 08 (Print Publication: 2024).
DOI:	10.7759/cureus.71050
Abstrakt:	Fingolimod is an oral disease-modifying treatment used for the relapsing-remitting forms of multiple sclerosis, which may render patients susceptible to opportunistic infections and lead to an increased risk of skin cancer. We report a 56-year-old woman with multiple sclerosis in remission on fingolimod treatment for five years presenting with the following skin lesions. Our patient presented with a non-healing ulcerated erythematous lesion on the left lower abdomen for six months and a crusted erythematous plaque on the forehead that had not healed for one year. Skin biopsy from the abdominal lesion showed fungal spores extending from the papillary dermis to the deep dermis, mostly in histiocytes and periodic acid-Schiff (PAS) staining revealed structures consistent with Cryptococcus . A moderate Cryptococcus neoformans infection was confirmed by culture. There were no systemic symptoms suggestive of secondary cutaneous cryptococcosis. In addition, a punch biopsy from the forehead showed findings compatible with Bowen's disease. Fingolimod was discontinued and the lesion on the left lower abdomen resolved with oral fluconazole therapy. Complete surgical excision with negative margin was performed for Bowen's disease. We present the first reported case of concurrent primary cutaneous cryptococcosis and Bowen's disease in the same patient with multiple sclerosis on fingolimod in the literature. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Gencebay et al.)
Databáze:	MEDLINE
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