Primary cutaneous coccidioidomycosis: It is a rare entity, first described in 1926, and since then, only about 20 cases have been reported.
The differentiation between a primary cutaneous coccidioidomycosis and a disseminated one without obvious pulmonary symptoms might be difficult, given the fact that their histology is the same and disseminated coccidioidomycosis may present a phenomenon called locus minoris resistentiae, where the organisms of the bloodstream have a predilection for lodging in areas with previous trauma (lacerations or punctures).
Disseminated cutaneous coccidioidomycosis: The dissemination to the skin compromises virtually any part of the body, but especially the face, neck, armpits, and groin (3,4).
Association between facial cutaneous coccidioidomycosis and meningitis.
Primary cutaneous coccidioidomycosis. J Am Acad Dermatol.