Cutaneous Coccidioidomycosis

Comments:
Cutaneous lesions in coccidioidomycosis are rare (5% of patients) and usually secondary to spread from the pulmonary sites. Primary cutaneous coccidioidomycosis is addressed in the next image. Certain groups are at higher risk of dissemination, including African-Americans, Hispanics, Filipinos, native Americans, and the immunocompromised.

The lesions are usually multiple and appear as ulcerated nodules, pustules, crusted plaques, or subcutaneous masses. There may be sinus tracts leading from the infection sites in the nearby bones, joints, or lymph nodes. Central face (especially the nasolabial fold) is a commonly affected location.