By Gary M. White, MD

Histoplasmosis--infection caused by the dimorphic fungus Histoplasma capsulatum--usually begins in the lungs after inhalation of the spores, which may be found in bird droppings, soil and bat guano.   When cutaneous lesions do occur, they usually result from dissemination of the pulmonary focus and the patient is usually immunocompromised (e.g. AIDS).   Primary cutaneous inoculation has rarely been reported.   The Ohio and Mississippi River valleys are endemic regions as is Puerto Rico.


A wide variety of skin lesions may be seen including papules, nodules, macules, and mucosal ulcers.


An infectious disease specialist should be consulted.


Two unusual cases of histoplasmosis in human immunodeficiency virus-infected individuals. Indian J Dermatol Venereol Leprol 2009;75:173-6


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