A Case of Generalized Cutaneous Candidiasis with Ringworm-like Lesions, Associated with Lymphocytic Lymphoma

Abstract

A thirty-year-old female patient, suffering from lymphocytic lymphoma, had multiple cutaneous lesions of candidiasis on her whole body surface. All of her cutaneous lesions of candidiasis consisted of quite round ring-shaped and papular plaques apparently looking like tinea circinata. The size of these circular lesions, however, remained mainly within 5cm in diameter, and several plaques frequently gathered together in a large ring-shaped arrangement as a whole, but these lesions never coalesced in one plaque each other. From the scales of the lesions Candida albicans was isolated constantly. In addition to these cutaneous lesions, oral and vaginal mucosa and finger- and toenails were affected with Candida albicans, too. The patient had suffered from these muco-cutaneous candidiasis for about two years, and then, one and a half year later, multiple indurated cutaneous nodules appeared on the extremities. Histologic examinations revealed that these nodules were poorly differentiated lymphocytic lymphoma (lymphosarcoma). Laboratory findings were showed remarkable suppression of cell-mediated immunity. It was suggested that these suppression of immune response of this patient played a role of a causative factor in the formation of these extraordinary ring-shaped lesions of cutaneous candidiasis. The lesions of cutaneous candidiasis except for nails were cleared by external applications of clotrimazole cream, but the patient died after five months treatments from acute and severe infiltrations of lymphoma-cells to the lung. The results of autopsy were also reported.