Ulcerative Blastomycosis Skin Lesion

57 asymptomatic M from Indiana nonpruritic, painless, progressive skin lesion lower back x 1yr. worse w/topical steroids. Denies any travel, animal exposure or adventurous hobbies. Lives in an old house & works as car mechanic. Diagnosis? 

Blastomycosis +biopsy, no other organ involvement, Ag neg, improved w/itraconazole

Blastomycosis- 2 types of skin lesions: verrucous (sharp borders) & ulcerative (heaped up borders); differential: basal cell ca, squamous cell ca, pyoderma gangrenosum, mycosis fungoides, keratocanthoma



- Indiana University Infectious Diseases Fellowship @IUIDfellowship



#Ulcerative #Blastomycosis #SkinRash #dermatology #clinical #photo