The specimen from the left cheek showed epidermal hyperplasia with intraepidermal granulomatous inflammation and small microabscesses. The papillary dermis was edematous, with capillary proliferation and lymphoplasmacytic inflammation. Granulomatous hyperplasia containing vacuolated giant cells was also present in the dermis. Methenamine silver staining demonstrated a broad-based yeast form consistent with blastomycosis (Figure 3, arrow).
Verrucous Facial Plaques—Diagnosis. Arch Dermatol. 2006;142(3):385-390. doi:10.1001/archderm.142.3.385-h