Localized cutaneous cryptococcosis successfully treated with itraconazole. Review of medication in 18 cases reported in Japan

A case of localized cutaneous cryptococcosis successfully treated with oral itraconazole is reported. The patient, a 63-year-old Japanese housewife, had had an erythematous and partly eroded lesion in the area of her right earlobe for about 10 months. No findings suggesting a primary focus of Cryptococcus infection were found in the lung, central nervous system or other internal organs. The isolate obtained from the lesion was identified as Cryptococcus neoformans based on the demonstration of encapsulated blastospores and its biological characteristics. The clinical course shifted toward healing in parallel with a decreased serum level of anticryptococcal antibody after initiation of treatment with oral itraconazole in a dose of 100 mg once daily. The treatment was discontinued after 13 weeks. There were neither subjective nor objective side effects. Furthermore, this paper reviews the medications employed in 18 cases with cutaneous cryptococcosis reported in Japan during the nearly 40-year period between 1952 and 1989.