Primary cutaneous Cryptococcosis during therapy with methotrexate and adalimumab.

Primary cutaneous infection with Cryptococcus neoformans is uncommon, but can occur following an inoculation injury to the skin. Tumor necrosis factor-alpha (TNF-alpha) is important in the immune response to Cryptococcus, and patients taking inhibitors of TNF-alpha may have increased susceptibility to cryptococcal infection. We report a case of primary cutaneous cryptococcosis in a patient taking adalimumab, methotrexate, and hydroxychloroquine for rheumatoid arthritis.

Calciphylaxis: natural history, risk factor analysis, and outcome.

Background: Calciphylaxis is characterized by ischemic cutaneous ulceration, high mortality, and ineffective treatment.

Methods: We conducted a retrospective study of 64 patients with calciphylaxis (including 49 dialysis patients age- and sex-matched to 98 dialysis controls).

Results: The estimated 1-year survival rate of calciphylaxis was 45.