​Dermatology - Histoplasmosis

​Dermatology - Histoplasmosis
Histoplasmosis is a fungal infection caused by the fungus Histoplasma capsulatum, which thrives in soil or the droppings of bats and birds. Acute pulmonary breakouts may result from work or recreational exposure.

Hypersensitivity skin reactions, such as erythema nodosum and erythema multiforme, may accompany or occur after a primary lung infection. Host-defense deficiencies in patients lead to cutaneous infection through the process of hematogenous spread.
Abnormalities
Papules or nodules manifest as red, dead tissue, or thickened skin. Additionally, there could be papulosquamous lesions resembling guttate psoriasis, pustules, papules resembling acne, persistent ulcers, plaques with vegetative growth, or inflammation of the subcutaneous fat layer known as panniculitis. The oral cavity may exhibit nodules, vegetations, or ulcerations.

The diagnosis is made based on clinical observations and validated with laboratory culture tests. The potential causes to consider are miliary tuberculosis, disseminated coccidioidomycosis, cryptococcosis, leishmaniasis, and lymphoma.


Administer oral fluconazole at a daily dose of 800 mg or itraconazole at a twice-day dose of 400 mg for a duration of 12 weeks. For patients with HIV illness who have not experienced immunological reconstitution, provide oral itraconazole at a daily dosage of 200 mg or oral fluconazole at a daily dosage of 400 mg. Administer intravenous amphotericin B to patients in critical condition.