A Case of Systemic Lupus Erythematosus Complicated by Cutaneous Chromomycosis and Cryptococcosis

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  • Hayashi Syujiro
    Department of Dermatology, Dokkyo University school of Medicine
  • Ohtsuka Tsutomu
    Department of Dermatology, Dokkyo University school of Medicine
  • Hashikabe Michio
    Department of Dermatology, Dokkyo University school of Medicine
  • Yamazaki Soji
    Department of Dermatology, Dokkyo University school of Medicine
  • Hase Isano
    Department of Pulmonary Medicine and Clinical Immunology, Dokkyo University school of Medicine
  • Takeda Akira
    Department of Pulmonary Medicine and Clinical Immunology, Dokkyo University school of Medicine
  • Fukuda Takeshi
    Department of Pulmonary Medicine and Clinical Immunology, Dokkyo University school of Medicine

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  • クロモミコーシスと皮膚クリプトコックス症を合併したSLEの1例
  • クロモミコーシス ト ヒフ クリプトコックスショウ オ ガッペイ シタ SLE ノ 1レイ

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Abstract

A case of systemic lupus erythematosus（SLE) presented with reddish-brown macules on her buttock of 22 years duration. She had been treated for SLE with oral predonisolone. Histological examination of the macule showed sclerotic cells in the dermis, and fungal culture showed chromomycosis. The macules improved with the treatment of intravenous fluconazole infusion. An ulcer with necrotic tissue was found on the her left dorsal side of hand. Histological examination showed yeast-like cells in the entire dermis. Fungal culture showed cryptococcosis. The ulcer improved with the treatment of intravenous fluconazole infusion. This case showed decreased CD4 positive lymphocytes and decreased IgG in her peripheral blood. These findings indicated that the decreased immune response led to the complication of chromomycosis and cryptococcosis for SLE.

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