[Acrochordons caused by friction from crutch use].

Actas Dermosifiliogr. 2009;100:77-83 80 immunocompromised as a result of corticotherapy—the most common risk factor in developing cryptococcosis3,4— although he had no history of trauma. The skin lesions, although uncommon due to their sporotrichoid appearance, were confined to uncovered areas. Serotype D organisms were not identified in our case. Our patient showed no systemic symptoms other than those related to his cancer, and the physical examination and complementary studies did not reveal any extracutaneous diseases. This fact, combined with the rapid resolution of the condition following administration of fluconazole, makes us consider cutaneous cryptococcosis as a primary diagnosis. Treatment of the primary form is not well established at present.2 Initial management tends to be medical, or a combination of medical treatment and surgical excision. Fluconazole (200-400 mg/d) is the most common agent prescribed, on average, for 32 days. For maintenance treatment in immunocompromised patients it is recommended that this drug be replaced with a less toxic alternative.1 The effectiveness of the therapy was remarkable in our patient, with full healing obtained in less than a month despite immunodepression and the absence of surgical intervention. In conclusion, we present a new case of primary cutaneous cryptococcosis with an uncommon sporotrichoid presentation in a patient with metastasic cancer on high doses of corticosteroid treatment. We also stress the excellent response to fluconazole. Acknowledgments