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. 
