Skin lesion of coccidioidomycosisSkin lesions of coccidioidomycosis are a manifestation in the skin of a fungal infection caused by Cocciodioides inmitis. Coccidioidomycosis is a fungal infection most often found in the desert regions of the southwestern US and in Central and
South America. It is acquired by inhaling fungal particles from soil in these regions. The portal of entry for this infection is the lung.
Up to one-half of affected individuals have mild or no symptoms. Immunosuppressed individuals, such as people with AIDS or cancer or transplant recipients, are at higher risk of severe, widespread (disseminated) disease.
Skin lesions can occur in the early stages of coccidioidomycosis (during primary lung infection). They include erythema nodosum or erythema multiforme. These rashes usually clear without treatment and are believed to be caused by an immune response to the infection.
After primary infection in the lungs, the fungus itself may spread to other tissues including the skin and lead to various skin lesions including papules, nodules, and ulcers. These lesions contain fungus within them and are a manifestation of disseminated (widespread) fungal disease.
The mainstay of treatment includes antifungal medications. Depending on the form or stage of disease, intravenous or oral preparations may be used. Antifungal agents commonly used include amphotericin B, itraconazole, ketoconazole, or fluconazole. People with disseminated disease and underlying immunosuppression may require long-term treatment.