Cutaneous cryptococcosis with molluscum contagiosum coinfection in a patient with acquired immunodeficiency syndrome.

We report the first patient with acquired immunodeficiency syndrome in whom molluscum contagiosum and Cryptococcus neoformans were documented in the same cutaneous lesion. While cases of the co-occurrence of two pathologic entities in patients with acquired immunodeficiency syndrome have been reported, namely cytomegalovirus with herpes simplex virus and Kaposi's sarcoma with Histoplasma capsulatum, the findings in this patient are unique. The clinical presentation of cutaneous lesions caused by molluscum contagiosum and by Cryptococcus neoformans is reviewed. The findings in this case are more remarkable still given the often-noted tendency of cutaneous cryptococcosis to masquerade as molluscum contagiosum. It may be that the lesions of molluscum contagiosum create a favorable environment for cryptococcal dissemination. Examination of a biopsy specimen is crucial to the diagnosis of skin lesions, often atypical or deceptive, in immunosuppressed patients.