Cutaneous fungal infections in HIV/AIDS.

Various cutaneous and mucocutaneous manifestations that are associated with HIV infection and AIDS from the superficial Candida albicans to systemic infections such as that caused by Histoplasma capsulatum are discussed. Specific topics cover superficial fungal infections such as blastomycosis, coccidioidomycosis, cryptoccosis, histoplasmosis, paracoccidioidomycosis, and sporotrichosis; and manifestations from systemic fungal infections caused by Cryptococcus neoformans and Penicillium marneffei. Diagnostic advice involving these conditions is offered. In the area of diagnosis, it is advised that when considering the possibility that a mucocutaneous lesion in an HIV-infected patient is secondary to dissemination of a systemic fungal infection, a tissue biopsy of that lesion should be performed for histologic evaluational and microbiologic cultures. Light microscopic examination after routine staining with hematoxylin-eosin and/or special staining for fungi with either periodic acid-Schiff or Gomori methenamine silver is also recommended in diagnosing a systemic fungal infection. Diagnostic molecular microbiology is making progress in expediting diagnosis of some of these infections, but it is not yet routinely available.