OBJECTIVE: Cryptococcus is an opportunistic yeast with a worldwide distribution 
that primarily causes significant infections in immunocompromised individuals, 
generally by affecting the respiratory tract. But primary cutaneous 
cryptococcosis (PCC) without systemic infection is rare. We report a case of PCC 
in a patient with nephrotic syndrome.
METHODS: The 23-year-old man developed severe necrotising cellulitis on both the 
anterior and posterior of his trunk following a massage. He had been treated 
with systemic corticosteroids over 20 months for nephrotic syndrome. A skin 
biopsy of the wound area revealed cutaneous vasculitis and chronic inflammation 
with yeast-like organisms. Periodic acid-Schiff (PAS) staining indicated that 
the structures were consistent with Cryptococcus. A Cryptococcus neoformans 
infection was confirmed by culture. Azole therapy was begun, and the skin ulcers 
gradually stopped disseminating. However, the patient died following continuous 
capillary haemorrhage on the 22 day since admission.
CONCLUSION: Cryptococcus is crucial to be considered in the differential 
diagnosis of subcutaneous necrosis in any patient on immunosuppressive therapy.