A patient with blastomycosis may develop mucosal or cutaneous lesions. The presence of mucocutaneous lesions often indicates systemic disease with multi-organ involvement.
Types of lesions:
(1) verrucous lesion
(2) ulcer
(3) subcutaneous or submucosal nodule
(4) pustular
(5) red papules or nodules (early)
Presentations:
(1) as part of an acute febrile illness
(2) with chronic pulmonary disease
(3) as the primary complaint
In the presence of pulmonary disease the organism presumably reaches the site via the hematogenous route. Direct inoculation into the skin may also occur; this is associated with regional lymphadenopathy.
Differential diagnosis:
(1) squamous cell carcinoma (A biopsy of a suspected skin carcinoma that is negative for tumor should be stained for fungi.)
(2) mycosis fungoides
(3) cutaneous leishmaniasis
To read more or access our algorithms and calculators, please log in or register.
