Cryptococcal dermatitis with negative antigenaemia heralding disseminated disease in HIV infection

Cutaneous involvement is reported to occur in nearly 10% of cases of disseminated cryptococcosis in AIDS patients. 1 The skin lesions may present with a fairly wide variety of clinical features 2'3 and are usually simultaneous to signs witnessing the presence of disseminated infection. 4's In some circumstances cutaneous cryptococcosis may be overtly recognizable when systemic signs and symptoms are not yet present, s'6 but microbiological markers (cryptococcal antigenaemia or isolation from blood) are regularly positive) We describe here two cases of AIDS-associated cryptococcal dermatitis which preceded by several weeks both the clinical onset of disseminated disease and the rise of formerly negative antigenaemia.