Primary cutaneous (accidental transcutaneous) infection with Blastomyces dermatitidis occurred in a patient. After accidental inoculation by a culture-carrying needle, a draining sore developed on the point of contact without demonstrable progression in lymph channels or lymph nodes. The lesions healed spontaneously. Therefore, primary cutaneous disease differs from the ordinary pulmonary infection by the development of a local chancre, generally with lymphangitis and lymphadenitis.
Landay ME, Schwarz J. Primary Cutaneous Blastomycosis. Arch Dermatol. 1971;104(4):408-411. doi:10.1001/archderm.1971.04000220066013