A Case of Cutaneous Cryptococcosis and Literature Review

Background When a patient presents with painful skin ulcers accompanied by purulent discharge and there is a possibility of immune deficiency, the potential for opportunistic pathogen infection should be considered. Case Presentation This report presents a case of a skin cryptococcal infection in a 68-year-old female patient who had been on long-term oral ruxolitinib due to myelofibrosis. The skin lesions were characterized by red plaques on the inner side of the right upper arm, accompanied by painful ulcers that had persisted for 9 months. Following an incision and drainage procedure locally, there was continuous purulent exudate that did not heal. Pathological examination indicated diffuse lymphocytic infiltration in the dermis, with a small number of neutrophils, and PAS staining was positive. Cultures of the purulent discharge revealed Cryptococcus neoformans in full view, with positive India ink staining. Serum cryptococcal antigen testing was positive, and after antifungal treatment and daily wound irrigation, the lesions healed. Conclusions This article briefly introduces the diagnosis and treatment process of the patient in this case and further analyzes the possible causes. Our literature review reveals that skin cryptococcosis lesions are typically non-specific, and clinical manifestations alone are insufficient for a definitive diagnosis. It is essential to maintain clinical vigilance and combine tissue pathology and microbiological examinations.