MARY S.STONEMDSOONBAHRAMIMDCARRIE ANN R.CUSACKMDSENAIT W.DYSONMDMOLLY A.HINSHAWMDVINCENTLIUMD
Histopathologic findings revealed pseudoepitheliomatous hyperplasia of the epidermis with pustulation of the epithelium and multinucleated giant cells within the thickened walls of follicular structures. The dermis exhibited a mixed infiltrate of plasma cells, lymphocytes, and neutrophils. The giant cells contained spheres 30- to 60-μm in diameter, which stained positively with Gomori methenamine silver and Alcian blue/periodic acid–Schiff. The combination of this observed endosporulation, along with DNA probe analysis, confirmed the diagnosis of coccidioidomycosis. Findings from subsequent sinus and chest radiographs were normal. After a course of oral ketoconazole, the lesions resolved without scarring.
An Exophytic Nasal Nodule—Diagnosis. Arch Dermatol. 2010;146(7):789-794. doi:10.1001/archdermatol.2010.150-b