The biopsy specimen showed marked pseudoepitheliomatous hyperplasia with intraepidermal microabscess formation. The dermis showed a dense infiltrate of neutrophils, giant cells, and spores lying both extracellularly and within multinucleated giant cells. The Gomori methenamine-silver stain showed yeast forms with broad-based budding.
The patient's chest x-ray film revealed no abnormalities, and magnetic resonance imaging of his face showed ethmoidal sinus involvement. The patient was originally treated with intravenous amphotericin B, followed by oral itraconazole. After 6 months of oral itraconazole therapy, the lesions have resolved, leaving behind residual scarring. His nasal airway is patent.
Verrucous Plaques on the Face. Arch Dermatol. 2000;136(4):547-552. doi: