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April 1982

North American BlastomycosisAn Unusual Clinical Manifestation

Author Affiliations

From the Departments of Dermatology (Drs Henchy and Omura) and Pathology (Drs Daniel and Kheir), University of Alabama in Birmingham.

Arch Dermatol. 1982;118(4):287-288. doi:10.1001/archderm.1982.01650160077032

North American blastomycosis is a multisystem disease that can involve virtually every organ in the body, with the skin being one of the salient sites of involvement. Our patient was initially seen with pustular skin lesions that differed notably from the skin changes commonly described in blastomycosis. We believe that this unusual manifestation is probably secondary to the patient's underlying leukemia or immunosuppression induced by therapy for his leukemic disease.

Report of a Case  A 65-year-old man, with a diagnosis of chronic lymphocytic leukemia, was referred on Sept 9, 1980, to the Veterans Administration Hospital of Birmingham, Ala, for evaluation of malaise, fever, and a pustular skin eruption.The patient had initially been seen at another hospital in July 1980 for malaise, calf pain, and painful swollen inguinal lymph nodes of two weeks' duration. There was a WBC count of 65,500/cu mm, with a differential cell count of 95% mature

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