Primary Cutaneous Cryptococcosis during Therapy with Methotrexate and Adalimumab

January 2008 | Volume 7 | Issue 1 | Case Reports | 53 | Copyright © January 2008

Morgan L. Wilson MD, Lindsay D. Sewell MD, Christen M. Mowad MD

Abstract
Primary cutaneous infection with Cryptococcus neoformans is uncommon, but can occur following an inoculation injury to the skin. Tumor necrosis factor-alpha (TNF-?) is important in the immune response to Cryptococcus, and patients taking inhibitors of TNF-? may have increased susceptibility to cryptococcal infection. We report a case of primary cutaneous cryptococcosis in a patient taking adalimumab, methotrexate, and hydroxychloroquine for rheumatoid arthritis.