Kaisu Pan,1 Danxia Lu,2 Weixuan Wu,1,3 Ping Luo,1,4 Liuwei Liao,1,5 Dong Liang,3 Wanqing Liao,6 Cunwei Cao,1 Dongyan Zheng1 

1Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, People’s Republic of China; 2Laboratory Department of Mashan County People’s Hospital, Nanning, 530600, People’s Republic of China; 3Fangchenggang Wanqing Institute of Dermatology and Fungal Disease Prevention and Control, Fangchenggang, 538000, People’s Republic of China; 4Guangxi Scientific and Technological Innovation Cooperation Base of Mycosis Prevention and Control, Nanning, 530022, People’s Republic of China; 5Guangxi Key Laboratory of Mycosis Research and Prevention, Nanning, 530022, People’s Republic of China; 6Mycology Center & Department of Dermatology, Changzheng Hospital, Shanghai, 200003, People’s Republic of China

Correspondence: Dongyan Zheng, Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, People’s Republic of China, Tel +86-771-5778736, Fax +86-21-64085875, Email zhdy705@163.com Cunwei Cao, Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, People’s Republic of China, Tel +86-771-5356514, Fax +86-21-64085875, Email caocunwei@yeah.net

Abstract: Cutaneous cryptococcosis is rarely caused by Naganishia albidus, especially in immunocompetent individuals. We report a unique case of perioral cutaneous infection in a 37-year-old male with scattered erythematous, pruritic, and scaly lesions lasting over a month. Initial clinical presentation mimicked common dermatological conditions, leading to potential misdiagnosis. Diagnosis was confirmed through fungal culture, fluorescence microscopy, MALDI-TOF mass spectrometry and molecular identification. The patient was successfully treated with oral itraconazole and topical fluconazole cream for six weeks. This case underscores the importance of considering rare fungal infections in atypical presentations to prevent misdiagnosis and delays in treatment.

Keywords: Naganishia albidus, perioral cutaneous infection, naganishial infection, antifungal therapy