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To the Editor. —We report a case of cutaneous cryptococcosis in a homosexual man with the acquired immunodeficiency syndrome (AIDS). This case is interesting because cutaneous lesions represented the only manifestation of cryptococcosis and the first manifestation of AIDS. A 48-year-old homosexual man, seropositive for the human immunodeficiency virus since 1987 (stage III, scale of the Centers for Disease Control, Atlanta, Ga), had been receiving zidovudine therapy since May 1990. In June 1990, he was referred to our center with a crusted lesion on the scalp that had developed in about 1 month. After removal of the crust, a round ulcer with an irregular border was visible (Fig 1). Partial regression was obtained with oral and local antibiotic therapy in about 2 weeks, but, 1 month later, the primary ulcer enlarged, and several secondary ulcerated nodules appeared on the scalp, face, trunk, and upper limbs. Skin specimens stained with hematoxylin-eosin

To the Editor.— Azidothymidine (zidovudine) is frequently used in the treatment of patients with acquired immunodeficiency syndrome (AIDS) or with AIDS-related complex. Side-effects during azidothymidine treatment are common and different. Bone marrow depression is the most relevant among them. 1 Recently, several patients affected by nail pigmentation have been described. 2 We describe two patients affected by pigmentation of the oral mucosa that appeared after the beginning of azidothymidine therapy. Report of Cases.—Case 1.— A 47-year-old homosexual man, who was anti-human immunodeficiency virus positive since 1986, began treatment with azidothymidine in March 1989, at a dose of 800 mg/d. After approximately 15 days, he developed three irregularly pigmented macules, ranging from 0.5- to 2-cm wide, on the lateral and upper sides of the tongue. The macules showed irregular borders and their color varied from yellowish to light brown. Neither hyperkeratosis nor infiltration was clinically appreciable. At the same time the patient presented with a single hyperpigmented longitudinal band on the thumbnail of the right hand.

To the Editor.— In patients with the acquired immunodeficiency syndrome (AIDS)- or human immunodeficiency virus (HIV)-related disorders, mucocutaneous manifestations caused by herpesvirus are frequent,1and may present with unusual clinical features.2Chronic anogenital ulcers due to herpes simplex virus (HSV), severe dermatomal herpes zoster (HZ), and protracted forms of varicella and vesiculobullous eruptions due to cytomegalovirus have all been described.3-5The purpose of this article is to illustrate a peculiar form of disseminated ecthymatous varicella zoster virus (VZV) infection in two patients with AIDS, which was characterized by necrotic cutaneous lesions and a prolonged course. Report of Cases.—Case 1. —A 35-year-old bisexual man with a history of varicella during childhood and condylomata acuminata for one year was found to be seropositive to HIV in May 1986, when he was hospitalized forPneumocystis cariniipneumonia and oral candidiasis. He developed cerebral toxoplasmosis in June 1986, and noted