A Case of Superficial Fungal Infection caused by Naganishia diffluens

Most superficial fungal infections of the skin are caused due to dermatophytosis or yeasts. However, it is rare for Cryptococcus species to cause infections. Among the fungal infections by Cryptotoccus species, Cryptococcus (C.) neoformans and C. gattii are the most common pathogenic species. However, other rare infections have been reported. Subcutaneous cryptococcosis due to Naganishia (N.) diffluens (formerly Cryptococcus diffluens) was first reported in Turkey. We present the case of a 53-year-old man who had mild pruritic annular, erythematous, scaly patches with inner small, crusted papules and nodules on both axilla and trunk for 3 months. A potassium hydroxide test on his abdomen scales was positive. Fungal culture, light microscopic findings, and the sequencing of an internal transcribed spacer of rRNA gene confirmed the presence of N. diffluens. As a result we diagnosed the patient with a superficial fungal infection caused by N. diffluens and treated it successfully with oral itraconazole and topical isoconazole.