An unusual case of dermatitis herpetiformis presenting with initial scalp localization.

620 areas), it is unclear whether they are an important reservoir for human infection or only a sentinel animal that is susceptible to infection from an environmental source. Human infections have been reported from traumatic implantation, inhalation of spores from soil, or possibly from a specific host plant.[5] Penicillium marneffei has been isolated from bamboo rat furrows and the current consensus would favor soil as the most probable reservoir, with transmission to humans via the respiratory root. Therefore, there seems to be no role for the rats on the natural occurrence of the disease. Similar to other pathogenic fungi, the conidia are inhaled and internalized by alveolar macrophages and transported to the reticuloendothelial system. The organisms then proliferate as soon as host immunodeficiency takes place, leading to systemic infection.[5] However, this remains to be proven and for now the natural habitat of the fungus and an explanation of its geographic restriction remains unknown.