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December 15, 2008

Edematous Nodules on the Extremities of a Febrile Patient—Diagnosis

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Copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2008

Arch Dermatol. 2008;144(12):1651-1656. doi:10.1001/archderm.144.12.1652-d

Histologic examination of the biopsy specimen revealed a hyperplastic epidermis with pseudoepitheliomatous hyperplasia and a lymphohistiocytic infiltrate filling the dermis (Figure 2). Note that Figure 2 shows tangential sectioning of the pseudoepitheliomatous hyperplasia. On higher magnification, multiple, round, encapsulated organisms consistent with Cryptococcus neoformans were evident in the deep dermis (Figure 3). After making the diagnosis, we treated our patient with liposomal amphotericin, which led to regression of his mucocutaneous lesions and resolution of his fevers.