45-year-old man with the Acquired Immunodeficiency Syndrome, on highly active antiretroviral therapy (HAART) resulting in rapid decline of HIV RNA and increase of CD4 T cells count, developed multiple skin umbilicated lesions (resembling molluscum contagiosum) on his face, ears, neck and chest. Histopathology and mycological cultures of a skin biopsy revealed Cryptococcus neoformans. Antigens of Cryptococcus was also identified in blood. During treatment with amphotericin B, the skin lesions regressed. This case demonstrates that skin lesions resembling molluscum contagiosum may be caused by cryptococcal infection. It is necessary to perform skin biopsy in HIV-infected persons with skin lesions to diagnose cutaneous cryptococcosis. The open question is if skin cryptococcosis may be the immune reconstruction disease.
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