{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T17:30:58Z","timestamp":1787679058715,"version":"build-2784847793"},"reference-count":47,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T00:00:00Z","timestamp":1661212800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"HCFMUSP-LIM50"},{"name":"National Council for Scientific"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>According to the spread of Cryptococcus sp., fungal infections can be classified as primary or secondary. In primary cutaneous cryptococcosis, the fungi are restricted to the skin of the patients, without systemic involvement. The incidence of primary cutaneous cryptococcosis is high in patients with immunosuppression, and this type of infection is rarely observed in patients who are immunocompetent. In the present case report, a patient who is immunocompetent and has systemic comorbidity reported that, after skin trauma, ulcerovegetative lesions appeared in the right upper arm; the etiologic agent was identified as Cryptococcus gatti, serotype B. The cutaneous lesions healed completely after 5 months of fluconazole treatment.<\/jats:p>","DOI":"10.3390\/tropicalmed7090206","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T02:55:34Z","timestamp":1661309734000},"page":"206","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Primary Cutaneous Cryptococcosis Caused by Cryptococcus gatti in an Elderly Patient"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0401-1885","authenticated-orcid":false,"suffix":"Jr.","given":"Walter","family":"Belda","sequence":"first","affiliation":[{"name":"Dermatology Department, Medical School, University of S\u00e3o Paulo, Clinics Hospital, S\u00e3o Paulo 05403-000, Brazil"},{"name":"Laboratory of Pathology of Infectious Diseases, Medical School, University of S\u00e3o Paulo, S\u00e3o Paulo 01246-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4858-4258","authenticated-orcid":false,"given":"Ana T. S.","family":"Casolato","sequence":"additional","affiliation":[{"name":"Dermatology Department, Medical School, University of S\u00e3o Paulo, Clinics Hospital, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana B.","family":"Luppi","sequence":"additional","affiliation":[{"name":"Dermatology Department, Medical School, University of S\u00e3o Paulo, Clinics Hospital, S\u00e3o Paulo 05403-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5986-6381","authenticated-orcid":false,"given":"Luiz Felipe D.","family":"Passero","sequence":"additional","affiliation":[{"name":"Institute of Biosciences, S\u00e3o Paulo State University (UNESP), S\u00e3o Vicente 11330-900, Brazil"},{"name":"Institute for Advanced Studies of Ocean, S\u00e3o Paulo State University (UNESP), S\u00e3o Vicente 11350-011, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9785-6099","authenticated-orcid":false,"given":"Paulo R.","family":"Criado","sequence":"additional","affiliation":[{"name":"ABC School of Medicine, Funda\u00e7\u00e3o Universit\u00e1ria do ABC (FUABC), Santo Andr\u00e9 09060-870, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Firacative, C., Trilles, L., and Meyer, W. (2021). Recent Advances in Cryptococcus and Cryptococcosis. Microorganisms, 10.","DOI":"10.3390\/microorganisms10010013"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.amjms.2020.12.007","article-title":"Disseminated Cryptococcosis in An Immunocompetent Host Presenting As Osteomyelitis and Leading to Adrenal Insufficiency","volume":"363","author":"Hsu","year":"2022","journal-title":"Am. J. Med. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1080\/1369378031000137224","article-title":"Primary cutaneous cryptococcosis in immunocompetent and immunocompromised hosts","volume":"41","author":"Christianson","year":"2003","journal-title":"Med. Mycol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1086\/322597","article-title":"Cryptococcosis in Human Immunodeficiency Virus\u2014Negative Patients in the Era of Effective Azole Therapy","volume":"33","author":"Pappas","year":"2001","journal-title":"Clin. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1080\/17843286.1996.11718496","article-title":"Cutaneous Cryptococcosis In Corticosteroid-Treated Patients Without Aids","volume":"51","author":"Vandersmissen","year":"1996","journal-title":"Acta Clin. Belg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"105521","DOI":"10.1016\/j.micpath.2022.105521","article-title":"A holistic review on Cryptococcus neoformans","volume":"166","author":"Rathore","year":"2022","journal-title":"Microb. Pathog."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Muselius, B., Durand, S.-L., and Geddes-McAlister, J. (2021). Proteomics of Cryptococcus neoformans: From the Lab to the Clinic. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms222212390"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Florek, M., Korzeniowska-Kowal, A., Wzorek, A., W\u0142odarczyk, K., Marynowska, M., Pogorzelska, A., Brodala, M., Ploch, S., Buczek, D., and Balon, K. (2021). Prevalence, Genetic Structure, and Antifungal Susceptibility of the Cryptococcus neoformans\/C. gattii Species Complex Strains Collected from the Arboreal Niche in Poland. Pathogens, 11.","DOI":"10.3390\/pathogens11010008"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1111\/j.1439-0507.2005.01079.x","article-title":"Two cases of cutaneous cryptococcosis","volume":"48","author":"Xiujiao","year":"2005","journal-title":"Mycoses"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"345","DOI":"10.5811\/cpcem.2021.5.52344","article-title":"Cryptococcus gattii Meningitis in a Previously Healthy Young Woman: A Case Report","volume":"5","author":"Maciey","year":"2021","journal-title":"Clin. Pr. Cases Emerg. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"193","DOI":"10.3201\/eid1702.101020","article-title":"Risk Factors for Cryptococcus gattii Infection, British Columbia, Canada","volume":"17","author":"MacDougall","year":"2011","journal-title":"Emerg. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1590\/S0036-46652002000400008","article-title":"Primary cutaneous cryptococcosis due to Cryptococcus neoformans var. gattii serotype B, in an immunocompetent patient","volume":"44","author":"Martins","year":"2002","journal-title":"Rev. Inst. Med. Trop. Sao. Paulo."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1111\/myc.12980","article-title":"Molecular typing of clinical and environmental isolates of Cryptococcus gattii species complex from southern California, United States","volume":"62","author":"Hurst","year":"2019","journal-title":"Mycoses"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2095","DOI":"10.3201\/eid2411.180975","article-title":"Timing the Origin of Cryptococcus gattii sensu stricto, Southeastern United States","volume":"24","author":"Lockhart","year":"2018","journal-title":"Emerg. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Campuzano, A., and Wormley, F. (2018). Innate Immunity against Cryptococcus, from Recognition to Elimination. J. Fungi, 4.","DOI":"10.3390\/jof4010033"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.1084\/jem.175.6.1685","article-title":"CD4+ T cells cause multinucleated giant cells to form around Cryptococcus neoformans and confine the yeast within the primary site of infection in the respiratory tract","volume":"175","author":"Hill","year":"1992","journal-title":"J. Exp. Med."},{"key":"ref_17","first-page":"e15185","article-title":"Lung Masses as a Presenting Sign of Disseminated Cryptococcus","volume":"13","author":"Tan","year":"2021","journal-title":"Cureus"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2119","DOI":"10.1097\/QAD.0b013e3282a4a64d","article-title":"HIV-associated cryptococcal meningitis","volume":"21","author":"Jarvis","year":"2007","journal-title":"AIDS"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1086\/313603","article-title":"Diagnosis and management of increased intracranial pressure in patients with AIDS and cryptococcal meningitis. The NIAID Mycoses Study Group and AIDS Cooperative Treatment Groups","volume":"30","author":"Graybill","year":"2000","journal-title":"Clin. Infect. Dis."},{"key":"ref_20","first-page":"518","article-title":"Endogenous Cryptococcal Endophthalmitis in Immunocompetent Host: Case Report and Review of Multimodal Imaging Findings and Treatment","volume":"26","author":"Amphornphruet","year":"2018","journal-title":"Ocul. Immunol. Inflamm."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1056\/NEJM197804132981506","article-title":"Cryptococcal endophthalmitis after corneal transplantation","volume":"298","author":"Beyt","year":"1978","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1128\/CMR.00126-13","article-title":"Cryptococcus gattii infections","volume":"27","author":"Chen","year":"2014","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1055\/s-0039-3400280","article-title":"Cryptococcosis","volume":"41","author":"Zavala","year":"2020","journal-title":"Semin. Respir. Crit. Care Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1093\/mmy\/myy086","article-title":"Pulmonary cryptococcosis: A review of pathobiology and clinical aspects","volume":"57","author":"Setianingrum","year":"2019","journal-title":"Med. Mycol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1378\/chest.129.2.333","article-title":"Pulmonary cryptococcosis: Comparison of clinical and radiographic characteristics in immunocompetent and immunocompromised patients","volume":"129","author":"Chang","year":"2006","journal-title":"Chest"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"101","DOI":"10.3314\/mmj.19.008","article-title":"Cutaneous Cryptococcosis","volume":"60","author":"Noguchi","year":"2019","journal-title":"Med. Mycol. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"740","DOI":"10.3389\/fmicb.2014.00740","article-title":"Skeletal cryptococcosis from 1977 to 2013","volume":"5","author":"Zhou","year":"2015","journal-title":"Front. Microbiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1517\/14656566.2012.658773","article-title":"Update on the epidemiology and management of cryptococcal meningitis","volume":"13","author":"Desalermos","year":"2012","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1097\/QAD.0b013e328322ffac","article-title":"Estimation of the current global burden of cryptococcal meningitis among persons living with HIV\/AIDS","volume":"23","author":"Park","year":"2009","journal-title":"AIDS"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.idc.2021.03.012","article-title":"Cryptococcosis","volume":"35","author":"Gushiken","year":"2021","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e01692021","DOI":"10.1590\/0037-8682-0169-2021","article-title":"Cryptococcosis by Cryptococcus neoformans\/Cryptococcus gattii Species Complexes in non-HIV-Infected Patients in Southeastern Brazil","volume":"54","author":"Nascimento","year":"2021","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1590\/S0074-02762008000500008","article-title":"Regional pattern of the molecular types of Cryptococcus neoformans and Cryptococcus gattii in Brazil","volume":"103","author":"Trilles","year":"2008","journal-title":"Mem. Inst. Oswaldo Cruz"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e170554","DOI":"10.1590\/0074-02760170554","article-title":"The status of cryptococcosis in Latin America","volume":"113","author":"Firacative","year":"2018","journal-title":"Mem. Inst. Oswaldo Cruz"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Firacative, C., Meyer, W., and Casta\u00f1eda, E. (2021). Cryptococcus neoformans and Cryptococcus gattii Species Complexes in Latin America: A Map of Molecular Types, Genotypic Diversity, and Antifungal Susceptibility as Reported by the Latin American Cryptococcal Study Group. J. Fungi, 7.","DOI":"10.3390\/jof7040282"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1086\/649858","article-title":"Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america","volume":"50","author":"Perfect","year":"2010","journal-title":"Clin. Infect. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"de Spadari, C.C., Wirth, F., Lopes, L.B., and Ishida, K. (2020). New Approaches for Cryptococcosis Treatment. Microorganisms, 8.","DOI":"10.3390\/microorganisms8040613"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3669","DOI":"10.1128\/JCM.01072-09","article-title":"Identification of Cryptococcus gattii by Use of l-Canavanine Glycine Bromothymol Blue Medium and DNA Sequencing","volume":"47","author":"Klein","year":"2009","journal-title":"J. Clin. Microbiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"110576","DOI":"10.1016\/j.pnpbp.2022.110576","article-title":"Age-associated alterations in immune function and inflammation","volume":"118","author":"Lewis","year":"2022","journal-title":"Prog Neuro-Psychopharmacol. Biol Psychiatry"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"388","DOI":"10.18683\/germs.2020.1232","article-title":"Fulminant cryptococcal meningoencephalitis after successful treatment of primary cutaneous cryptococcosis","volume":"10","author":"Romiopoulos","year":"2020","journal-title":"GERMS"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"15","DOI":"10.5070\/D32612051361","article-title":"Disseminated cryptococcosis presenting with cutaneous involvement in an immunocompromised patient","volume":"26","author":"Bardhi","year":"2020","journal-title":"Dermatol. Online J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.dsi.2012.07.001","article-title":"Primary cutaneous cryptococcosis in an immunocompetent man: A case report","volume":"31","author":"Lu","year":"2013","journal-title":"Dermatol. Sin."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"154","DOI":"10.5114\/ada.2020.94833","article-title":"Cutaneous cryptococcosis: An underlying immunosuppression? Clinical manifestations, pathogenesis, diagnostic examinations and treatment","volume":"37","author":"Nowak","year":"2020","journal-title":"Adv. Dermatol. Allergol.\/Post\u0119py Dermatol. i Alergol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1590\/abd1806-4841.20164582","article-title":"Disseminated cryptococcosis manifested as a single tumor in an immunocompetent patient, similar to the cutaneous primary forms","volume":"91","author":"Carneiro","year":"2016","journal-title":"An. Bras. Dermatol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"7068287","DOI":"10.1155\/2016\/7068287","article-title":"Differential Recruitment of Dendritic Cells Subsets to Lymph Nodes Correlates with a Protective or Permissive T-Cell Response during Leishmania (Viannia) Braziliensis or Leishmania (Leishmania) Amazonensis Infection","volume":"2016","author":"Carvalho","year":"2016","journal-title":"Mediat. Inflamm."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Ribeiro, S.P., Milush, J.M., Cunha-Neto, E., Kallas, E.G., Kalil, J., Passero, L.F.D., Hunt, P.W., Deeks, S., Nixon, D.F., and Sengupta, D. (2016). P16INK4a expression and immunologic aging in chronic HIV infection. PLoS ONE., 11.","DOI":"10.1371\/journal.pone.0166759"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1067\/mjd.2000.100961","article-title":"Primary cutaneous cryptococcosis of the nose in an immunocompetent woman","volume":"43","author":"Patel","year":"2000","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1684\/ejd.2021.4143","article-title":"Extensive leg ulcer caused by primary cutaneous cryptococcosis in an immunocompromised patient","volume":"31","author":"Inoue","year":"2021","journal-title":"Eur. J. Dermatol."}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/7\/9\/206\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:14:00Z","timestamp":1760141640000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/7\/9\/206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,23]]},"references-count":47,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["tropicalmed7090206"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed7090206","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,23]]}}}