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Cutaneous histoplasmosis with an intraepithelial\u2010predominant distribution has not been described.<\/jats:p><jats:p>A 47\u2010year\u2010old man was admitted to our institution with fever and vancomycin\u2010resistant enterococcal bacteremia. He had been diagnosed with T\u2010cell prolymphocytic leukemia 4 years earlier and had undergone matched\u2010unrelated\u2010donor stem cell transplant 2 years earlier; on admission, he had relapsed disease. His medical history was significant for disseminated histoplasmosis 6 months before admission, controlled with multiple antifungal regimens. During this final hospitalization, the patient developed multiple 2\u20135 mm erythematous papules, a hemorrhagic crust across the chest, shoulders, forearms, dorsal aspect of the fingers, abdomen and thighs. Skin biopsy revealed clusters of oval yeast forms mostly confined to the cytoplasm of keratinocytes and within the stratum corneum; scattered organisms were present in the underlying superficial dermis without any significant associated inflammatory infiltrate. Special stains and immunohistochemical studies confirmed these to be <jats:italic>Histoplasma<\/jats:italic> organisms.<\/jats:p><jats:p>We highlight this previously unrecognized pattern of cutaneous histoplasmosis to ensure its prompt recognition and appropriate antifungal therapy.<\/jats:p>","DOI":"10.1111\/cup.12792","type":"journal-article","created":{"date-parts":[[2016,8,12]],"date-time":"2016-08-12T08:17:25Z","timestamp":1470989845000},"page":"1155-1160","source":"Crossref","is-referenced-by-count":10,"title":["Cutaneous histoplasmosis with prominent parasitization of epidermal keratinocytes: report of a case"],"prefix":"10.1111","volume":"43","author":[{"given":"Hedieh H.","family":"Honarpisheh","sequence":"first","affiliation":[{"name":"Department of Pathology University of Texas MD Anderson Cancer Center  Houston TX USA"},{"name":"Department of Pathology Duke University School of Medicine  Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan 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