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September 1988

An Unusual Fungal Infection in an Immunocompromised Oncology Patient

Author Affiliations

Johns Hopkins Hospital, Baltimore

Arch Dermatol. 1988;124(9):1421-1422. doi:10.1001/archderm.1988.01670090077019

REPORT OF A CASE  A 69-year-old man presented to the oncology outpatient clinic with a three-day history of suprapatellar pruritic cutaneous lesions and was admitted to the hospital. The diagnosis of glioblastoma multiforme had been made five months earlier. Following partial surgical removal of the tumor, chemotherapy was begun (cisplatin and carmustine). The patient had a history of hypertension and diabetes mellitus. Medications he was receiving on admission to the hospital included dexamethasone (40 mg/d orally), subcutaneous insulin (injected into the left arm), diazide, and captopril. He had no complaints referable to his pulmonary, cardiac, or renal systems.On physical examination, there were warm, 1-cm tender, macular and papular, centrally necrotic lesions on both knees (Fig 1) and nontender macular lesions on his left ring finger and left shin. Results of cardiopulmonary and abdominal examinations were within normal limits and results of a neurologic examination were unchanged from previously. His

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