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American Journal of Clinical Dermatology

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01-10-2020 | Amphotericin B | Review Article

Primary Cutaneous Coccidioidomycosis: An Update

Authors: Irving Llibran Reyna-Rodríguez, Jorge Ocampo-Candiani, Sonia Chavez-Alvarez

Published in: American Journal of Clinical Dermatology | Issue 5/2020

Abstract

Coccidioidomycosis is an endemic mycosis of the southern United States, Northern Mexico, and South America. Primary cutaneous coccidioidomycosis, despite being a very rare clinical presentation, has shown an increasing incidence. An extensive literature search for cutaneous coccidioidomycosis cases was performed using the OLDMEDLINE, PubMed, Cochrane, LILACS and Google Scholar databases for studies published from January 1927 through December 21, 2019. Forty-two observational studies were included totaling 82 cases of primary cutaneous coccidioidomycosis. Narrative reviews, systematic reviews, and meta-analyses were also included. Additionally, an original case was included. Patients with primary cutaneous coccidioidomycosis share the same geographical and epidemiological characteristics as those with pulmonary or disseminated coccidioidomycosis. Most of the imported cases came from endemic areas. A large portion of cases had prior local skin trauma. Tissue culture is still the leading diagnostic method; nevertheless, molecular techniques such as polymerase chain reaction (PCR) are currently relevant to differentiate between species. First-line treatment consists of azoles; however, it has an excellent prognosis even without treatment. Primary cutaneous coccidioidomycosis should be considered a differential diagnosis of unusual infections or neoformations in any part of the body in resident populations of endemic areas or in patients with a previous history of travel to these areas.

Posadas A. Un nuevo caso de micosis fungoidea con posrospemias. An Cir Med Argent. 1892;15:585–97.

Laniado-Laborín R, Arathoon EG, Canteros C, Muñiz-Salazar R, Rendon A. Coccidioidomycosis in Latin America. Med Mycol. 2019;57:46–55. https://doi.org/10.1093/mmy/myy037.CrossRef

Hirschmann JV. The early history of coccidioidomycosis: 1892–1945. Clin Infect Dis. 2007;44(9):1202–7. https://doi.org/10.1086/513202.CrossRefPubMed

Deresinski S, Mirels LF. Coccidioidomycosis: what a long strange trip it’s been. Med Mycol. 2019;57(Supplement_1):3–15. https://doi.org/10.1093/mmy/myy123.CrossRef

Kollath DR, Miller KJ, Barker BM. The mysterious desert dwellers: Coccidioides immitis and Coccidioides posadasii, causative fungal agents of coccidioidomycosis. Virulence. 2019;10:222–33. https://doi.org/10.1080/21505594.2019.1589363.CrossRefPubMedPubMedCentral

Overholt EL, Hornick RB. Primary cutaneous coccidioidomycosis. Arch Intern Med. 1964;114(1):149. https://doi.org/10.1001/archinte.1964.03860070195028.CrossRefPubMed

Carroll GF, Haley LD, Brown JM. Primary cutaneous coccidioidomycosis: a review of the literature and a report of a new case. Arch Dermatol. 1977;113(7):933–6. https://doi.org/10.1001/archderm.1977.01640070067008.CrossRefPubMed

Twarog M, Thompson G. Coccidioidomycosis: recent updates. Semin Respir Crit Care Med. 2015;36(05):746–55. https://doi.org/10.1055/s-0035-1562900.CrossRefPubMed

Liu H, Zhao Y, Yi F, et al. Clinical features of coccidioidomycosis: analysis of 33 Chinese Cases. Acta Acad Med Sin. 2019;41:646–57. https://doi.org/10.3881/j.issn.1000-503X.10884.CrossRef

10.

Bonifaz A, Tirado-Sánchez A, González G. Cutaneous coccidioidomycosis with tissue arthroconidia. Am J Trop Med Hyg. 2019;100:772–772. https://doi.org/10.4269/ajtmh.18-0700.CrossRefPubMedPubMedCentral

11.

Shiu J, Thai M, Elsensohn AN, Nguyen NQ, Lin KY, Cassarino DS. A case series of primary cutaneous coccidioidomycosis after a record-breaking rainy season. JAAD Case Rep. 2018;4(5):412–4. https://doi.org/10.1016/j.jdcr.2017.11.018.CrossRefPubMedPubMedCentral

12.

Russell DH, Ager E, Wohltman W. Cutaneous coccidiomycosis masquerading as an epidermoid cyst: case report and review of the literature. Milit Med. 2017;182(1):e1665–e16681668. https://doi.org/10.7205/milmed-d-15-00549.CrossRef

13.

Perez-Elizondo AD. Coccidioidomicosis cutánea. Imagen clínica. Rev Argent Dermatol. 2017; 98(4). https://radonline.org.ar/2018/01/01/coccidiodomicosis-cutanea-imagen-clinica/.

14.

Rivard SC, Satter E. Primary cutaneous coccidioidomycosis presenting as a recurrent preauricular cyst. Skinmed. 2016;14(2):142–4.PubMed

15.

Muñoz-Estrada VF, Verdugo-Castro PN, Muñoz- MR. Coccidioidomicosis cutánea primaria. Dermatol Rev Mex. 2016;60(6):531–5.

16.

Moreno-Coutiño G, Arce M, Medina A, Amarillas-Villalva A, Salas-Vargas V, Madrigal-Kazem R, Arenas R. Coccidioidomicosis cutánea: Comunicación de seis casos mexicanos. Rev Chilena Infectol. 2015;32(3):339–43. https://doi.org/10.4067/s0716-10182015000400014.CrossRefPubMed

17.

Garcia-Garcia SC, Salas-Alanis JC, Gomez-Flores M, Gonzalez-Gonzalez SE, Vera-Cabrera L, Ocampo-Candiani J. Coccidioidomycosis and the skin: a comprehensive review. An Bras Dermatol. 2015;90(5):610–21.PubMed

18.

Beatty N, Al Mohajer M. Medical image of the week: cutaneous coccidioidomycosis. Southwest J Pulm Crit Care. 2015;11(5):226–7. https://doi.org/10.13175/swjpcc110.CrossRef

19.

Tortorano AM, Carminati G, Tosoni A, Tintelnot K. Primary cutaneous coccidioidomycosis in an Italian Nun working in South America and Review of Published Literature. Mycopathologia. 2015;180(3–4):229–35. https://doi.org/10.1007/s11046-015-9895-0.CrossRefPubMed

20.

Dworak DP, Kapustiak J, Ehklassi TA, Patrianakos TD. Primary cutaneous coccidioidomycosis of the eyelid: a case report. Ophthal Plast Reconstr Surg. 2014;32(2):e40–e4141. https://doi.org/10.1097/IOP.0000000000000224(Epub ahead of print).CrossRef

21.

Narang V, Garg B, Sood N, Goraya SK. Primary cutaneous coccidioidomycosis: first imported cases in north India. Indian J Dermatol. 2014;59:422.PubMedPubMedCentral

22.

Rojas-Garcia OC, Moreno-Treviño MG, Gonzalez-Salazar F, Salas-Alanis JC. Coccidioidomycosis cutanea primaria en infante. Gac Med Mex. 2014;150:175–6.PubMed

23.

Di Martino-Ortiz B, Riveros R, Rodriguez-Masi R, Bolla-de-Lezcano L. Coccidioidomicosis cutánea primaria. Piel (Barc). 2014;2(8):477–80. https://doi.org/10.1016/j.piel.2014.01.018.CrossRef

24.

Welsh O, Vera-Cabrera L, Rendon A, Gonzalez G, Bonifaz A. Coccidioidomycosis. Clin Dermatol. 2012;30:573–91.PubMed

25.

Salas-Alanis JC, Ocampo-Candiani J, Cepeda-Valdes R, Gomez-Flores M, Bonifaz A. Primary cutaneous coccidioidomycosis: incidental finding. J Clin Exp Dermatol. 2012;3:2. https://doi.org/10.4172/2155-9554.1000147.CrossRef

26.

Muñoz-Estrada VF, Tolosa MR, Paz BGAV. Coccidioidomicosis cutánea primaria: presentación de un caso con morfología Atípica. Rev Med UAS. 2012;3:141–4.

27.

Ondo AL, Zlotoff BJ, Mings SM, Rochester LC, Shanler SD. Primary cutaneous coccidioidomycosis: an incidental finding. Clin Exp Dermatol. 2010;35(3):e42–e4343. https://doi.org/10.1111/j.1365-2230.2009.03552.x.CrossRefPubMed

28.

Gaidici A, Saubolle MA. Transmission of coccidioidomycosis to a human via a cat bite. J Clin Microbiol. 2009;47(2):505–6. https://doi.org/10.1128/JCM.01860-08.CrossRefPubMed

29.

Gao W, Zhang SL, Zhang XM, Zou Q. Case report of a primary cutaneous coccidioidomycosis and literature review. Pract Med. 2008;24(7):1262–3 (in Chinese).

30.

Jaramillo-Moreno G, Velazquez-Arenaz L, Mendez-Olvera N, Ocampo-Candiani J. Primary cutaneous coccidioidomycosis: case report and review of the literature. Intern J Dermatol. 2006;45:121–3.

31.

Chang A, Tung RC, McGillis TS, Bergfeld WF, Taylor JS. Primary cutaneous coccidioidomycosis. J Am Acad Dermatol. 2003;49:944–9.PubMed

32.

Kim A, Parker SS. Coccidioidomycosis: case report and update on diagnosis and management. J Am Acad Dermatol. 2002;46:743–7.PubMed

33.

Domínguez-Cota G, Zamora-Angulo LE, Osuna-Beltrán, E, Vega Rosas, CE, Coccidioidomicosis cutánea primaria. Estudio epidemiológico y clínico. Serie de 16 casos. CIMEL Ciencia e Investigación Médica Estudiantil Latinoamericana. 2001; 6:49–53. https://www.researchgate.net/publication/26619059_Coccidioidomicosis_cutanea_primaria_Estudio_epidemiologico_y_clinico_Serie_de_16_casos.

34.

Bonifaz A, Saul A, Galindo J, Andrade R. Primary cutaneous coccidioidomycosis treated with itraconazole. Int J Dermatol. 1994;33:720–2.PubMed

35.

Fusaro RM, Bansal S, Records RE. Some unusual periorbital dermatoses. Ann Ophthalmol. 1988;20:391–3.PubMed

36.

Zhu JJ, Luo YL, Liu JS. One case of skin coccidioidomycosis complex Kaposi sarcoma in AIDS patient. Chin J Dermatol. 1998;12(4):232–3.

37.

Male O. Coccidioidomykose. Pilzdialog. 1987;3:39–40.

38.

Franco-de-Arias CM, Segundo B, Mejía-de-Alejos MA, et al. Coccidioidomicosis experiencia clínica y terapeutica. Dermatol Venezol. 1986;24:2–4.

39.

O’Brien JJ, Gilsdorf JR. Primary cutaneous coccidioidomycosis in childhood. Pediatr Infect Dis. 1986;5:485–6.PubMed

40.

Schwartz RA, Lamberts RJ. Isolated nodular cutaneous coccidioidomycosis. The initial manifestation of disseminated disease. J Am Acad Dermatol. 1981;4:38–46.PubMed

41.

Gonzalez-Ochoa A, Velasco-Castrejon O. Inoculacion primaria accidental de coccidioidomycosis a partir de un caso clinico. Rev Invest Salud Publica. 1976;36:227–33.PubMed

42.

Winn WA. Primary cutaneous coccidioidomycosis: reevaluation of its potentiality based on a study of three new cases. Arch Dermatol. 1965;92:221–8.PubMed

43.

Levan NE, Huntington RW. Primary cutaneous coccidioidomycosis in agricultural workers. Arch Dermatol. 1965;92:215–20.PubMed

44.

Sorenson RH, Cheu SH. Accidental cutaneous coccidioidomycosis in an immune person. Calif Med. 1964;100:44–7.

45.

Goodman DH, Schabarum B. Primary cutaneous coccidioidomycosis: visible classic demonstration of delayed hypersensitivity. Ann Intern Med. 1963;59:84–90.PubMed

46.

Harrell ER, Honeycutt WM. Coccidiodomycosis: traveling fungus disease. Arch Dermatol. 1963;87:188–96.PubMed

47.

Smith CE, Pappagianis D, Levine HB, Saito MT. Human coccidioidomycosis. Bacteriol Rev. 1961;25:314–5.

48.

Wright ET, Newcomer VD, Nelson NH. Primary inoculation coccidioidomycosis. Arch Dermatol. 1959;79:118–20.

49.

Gan D, Guo ML, He YG. First case of primary cutaneous coccidioidomycosis. Chin J Pathol. 1958;2:107–14 (in Chinese).

50.

Trimble JR, Doucette J. Primary cutaneous coccidioidomycosis: report of a case of a laboratory infection. Arch Dermatol. 1956;74:405–10.

51.

Wilson JW, Smith CE, Plunkett OA. Primary cutaneous coccidioidomycosis; the criteria for diagnosis and a report of a case. Calif Med. 1953;79:233–9.PubMedPubMedCentral

52.

Imerman SW, Imerman CP. Granuloma coccidioides, primary cutaneous lesión: Treatment with the actual cautery: report of a case. Southwest Med. 1993;17:18–211.

53.

Guy WH, Jacob FM. Granuloma coccidioides. Arch Dermatol. 1927;16:308–11.

54.

Van Dyke MCC, Thompson GR, Galgiani JN, Barker BM. The rise of coccidioides: forces against the dust devil unleashed. Front Immunol. 2019;10:2188. https://doi.org/10.3389/fimmu.2019.02188.CrossRefPubMedPubMedCentral

55.

Ampel NM. The complex immunology of human coccidioidomycosis. Ann N Y Acad Sci. 2007;1111(1):245–58. https://doi.org/10.1196/annals.1406.032.CrossRefPubMed

56.

Kirkland T. The quest for a vaccine against coccidioidomycosis: a neglected disease of the Americas. J Fungi. 2016;2(4):34. https://doi.org/10.3390/jof2040034.CrossRef

57.

Kaffenberger BH, Shetlar D, Norton SA, Rosenbach M. The effect of climate change on skin disease in North America. J Am Acad Dermatol. 2017;76(1):140–7. https://doi.org/10.1016/j.jaad.2016.08.014.CrossRefPubMed

58.

Bialek B, Kern J, Hermann T, et al. PCR assays for identification of Coccidioides posadasii based on the nucleotide sequence of the antigen 2/proline-rich antigen. J Clin Microbiol. 2004;42:778–83.PubMedPubMedCentral

59.

McCotter OZ, Benedict K, Engelthaler DM, et al. Update on the epidemiology of coccidioidomycosis in the United States. Med Mycol. 2019;57(Supplement_1):S30–S40. https://doi.org/10.1093/mmy/myy095.CrossRefPubMedPubMedCentral

60.

Benedict K, McCotter OZ, Brady S, et al. No. SS-7. MMWR Surveill Summ. 2019;68:1–15.PubMedPubMedCentral

61.

Galgiani JN, Ampel NM, Blair JE, et al. Infectious Diseases Society of America (IDSA) clinical practice guideline for the treatment of coccidioidomycosis. Clin Infect Dis. 2016;63(6):e112–e14646. https://doi.org/10.1093/cid/ciw360.CrossRefPubMed

62.

Lynch FH, Maly CJ, Unwala R, Blair JE, DiCaudo DJ, Mangold AR. Disseminated coccidioidomycosis mimicking cicatricial alopecia. JAAD Case Rep. 2019;5(11):957–9. https://doi.org/10.1016/j.jdcr.2019.08.024.CrossRefPubMedPubMedCentral

63.

Watson IT, Murzaku E. Cutaneous coccidiomycosis presenting with a facial plaque. Proc (Bayl Univ Med Cent). 2019. https://doi.org/10.1080/08998280.2018.1523643.CrossRefPubMedPubMedCentral

64.

Stockamp NW, Thompson GR. Coccidioidomycosis. Infect Dis Clin N Am. 2016;30(1):229–46. https://doi.org/10.1016/j.idc.2015.10.008.CrossRef

65.

Carpenter JB, Feldman JS, Leyva WH, DiCaudo DJ. Clinical and pathologic characteristics of disseminated cutaneous coccidioidomycosis. J Am Acad Dermatol. 2010;62(5):831–7.PubMed

66.

Odio CD, Marciano BE, Galgiani JN, Holland SM. Risk factors for disseminated coccidioidomycosis, United States. Emerg Infect Dis. 2017;23:308–11. https://doi.org/10.3201/eid2302.160505.CrossRefPubMedCentral

67.

Gabe LM, Malo J, Knox KS. Diagnosis and management of coccidioidomycosis. Clin Chest Med. 2017;38(3):417–33. https://doi.org/10.1016/j.ccm.2017.04.005.CrossRefPubMed

68.

Levine HB, Cobb JM, Smith CE. Immunity to coccidioi-domycosis induced in mice by purified spherule, arthrospore, and mycelial vaccines. Trans N Y Acad Sci. 1960;22:436–49. https://doi.org/10.1111/j.2164-0947.1960.tb00711.x.CrossRefPubMed

69.

Porte L, Valdivieso F, Wilmes D, et al. Laboratory exposure to Coccidioides: lessons learnt in a non-endemic country. J Hosp Inf. 2019;102:461–4. https://doi.org/10.1016/j.jhin.2019.03.006.CrossRef

70.

Johnson R, Kernerman SM, Sawtelle BG, et al. A reformulated spherule-derived Coccidioidin (Spherusol) to detect delayed-type hypersensitivity in coccidioidomycosis. Mycopathologia. 2012;174(5–6):353–8.PubMed

71.

Galgiani JN. Coccidioidomycosis. West J Med. 1993;159(2):153–71.PubMedPubMedCentral

72.

Vucicevic D, Blair JE, Binnicker MJ, et al. The utility of Coccidioides polymerase chain reaction testing in the clinical setting. Mycopathologia. 2010;170(5):345–51.PubMed

73.

Engelthaler DM, Roe CC, Hepp CM, et al. Local population structure and patterns of western hemisphere dispersal for Coccidioides spp, the fungal cause of valley fever. MBio. 2016;7(2):e00550–e616 (Epub 2016/04/28).PubMedPubMedCentral

74.

van den Bossche H, Willemsens G, Cools W, Lauwers WF, Le Jeune L. Biochemical effects of miconazole on fungi. II. inhibition of ergosterol biosynthesis in Candida albicans. Chem Biol Interact. 1978;21:59–78.PubMed

75.

Thompson GR, Lewis JS, Nix DE, Patterson TF. Current concepts and future directions in the pharmacology and treatment of coccidioidomycosis. Med Mycol. 2019;57:S76–84. https://doi.org/10.1093/mmy/myy029.CrossRefPubMed

76.

Roden MM, Nelson LD, Knudsen TA, et al. Triad of acute infusion-related reactions associated with liposomal amphotericin B: analysis of clinical and epidemiological characteristics. Clin Infect Dis. 2003;36:1213–20. https://doi.org/10.1086/374553.CrossRefPubMed

77.

DiCaudo DJ. Coccidioidomycosis: a review and update. J Am Acad Dermatol. 2006;55(6):929–42. https://doi.org/10.1016/j.jaad.2006.04.039.CrossRefPubMed

78.

Gonzalez GM, Gonzalez G, Najvar LK, et al. Therapeutic efficacy of caspofunginalone and in combination with amphotericin B deoxycholate for coccidioidomycosis in a mouse model. J Antimicrob Chemother. 2007;60(6):1341–6.PubMed

79.

Levy ER, McCarty JM, Shane AL, et al. Treatment of pediatric refractory coccidioidomycosis with combination voriconazole and caspofungin: a retrospective case series. Clin Infect Dis. 2013;56(11):1573–8.PubMed

80.

Krogstad P, Johnson R, Garcia-Lloret MI, Heidari A, Butte MJ. Host–pathogen interactions in coccidioidomycosis: prognostic clues and opportunities for novel therapies. Clin Ther. 2019;41(10):1939–1954.e1. https://doi.org/10.1016/j.clinthera.2019.08.011.CrossRefPubMed

81.

Malaguarnera L, Musumeci M, Di Rosa M, Scuto A, Musumeci S. Interferon-gamma, tumor necrosis factor-alpha, and lipopolysaccharide promote chitotriosidase gene expression in human macrophages. J Clin Lab Anal. 2005;19:128e132.

82.

Levine HB, Cobb JM, Smith CE. Immunity to coccidioidomycosis induced in mice by purified spherule, arthrospore, and mycelial vaccines. Trans N Y Acad Sci. 1960;22:436–49. https://doi.org/10.1111/j.2164-0947.1960.tb00711.x.CrossRefPubMed

83.

Pappagianis D. Evaluation of the protective efficacy of the killed Coccidioides immitis spherule vaccine in humans. The Valley Fever Vaccine Study Group. Am Rev Respir Dis. 1993;148:656–60. https://doi.org/10.1164/ajrccm/148.3.656.CrossRefPubMed

84.

Hung CY, Hsu AP, Holland SM, Fierer J. A review of innate and adaptive immunity to coccidioidomycosis. Med Mycol. 2019;57(Supplement_1):S85–S92. https://doi.org/10.1093/mmy/myy146.CrossRefPubMedPubMedCentral

85.

Saville SP, Lazzell AL, Chaturvedi AK, Monteagudo C, Lopez-Ribot JL. Efficacy of a genetically engineered Candida albicans tet-NRG1 strain as an experimental live attenuated vaccine against hematogenously disseminated candidiasis. Clin Vaccine Immunol. 2009;16:430–2. https://doi.org/10.1128/CVI.00480-08.CrossRefPubMedPubMedCentral

86.

Trinh SA, Echenique IA, Penugonda S, Angarone MP. Safety and efficacy of chronic suppressive azole therapy for endemic fungal infections in solid organ transplant recipients. Transpl Infec Dis. 2018;20(5):e12963. https://doi.org/10.1111/tid.12963.CrossRef

Title: Primary Cutaneous Coccidioidomycosis: An Update
Authors: Irving Llibran Reyna-Rodríguez
Jorge Ocampo-Candiani
Sonia Chavez-Alvarez
Publication date: 01-10-2020
Publisher: Springer International Publishing
Keywords: Amphotericin B
Itraconazole
Published in: American Journal of Clinical Dermatology / Issue 5/2020
Print ISSN: 1175-0561
Electronic ISSN: 1179-1888
DOI: https://doi.org/10.1007/s40257-020-00525-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Primary Cutaneous Coccidioidomycosis: An Update

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Keynote webinar | Spotlight on medication adherence

Springer Medicine

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