Concomitant psoriasis, seborrheic dermatitis, and disseminated cutaneous histoplasmosis in a patient infected with human immunodeficiency virus

Cutaneous involvement with disseminated histoplasmosis occasionally occurs in patients infected with the human immunodeficiency virus. We describe a profoundly immunocompromised patient with acquired immunodeficiency syndrome who had concomitant psoriasis, seborrheic dermatitis, and disseminated histoplasmosis, each with similar features. Findings of a skin biopsy specimen from a lesion on the forehead showed an infiltrate of histiocytes filled with Histoplasma capsulatum. In disseminated histoplasmosis involvingthe skin, lesions may have features more characteristic of a papulosquamous dermatosis than an infectious disease. In patients infected with human immunodeficiency virus, especially those with low numbers of CD4+ cells, serious infectious diseases may have unusual features and may assume the appearance of concomitant inflammatory diseases.