MICHAEL E.MINGMD, MSCE
CARRIE ANN R.CUSACKMDJACQUELINE M.JUNKINS-HOPKINSMDVINCENTLIUMDKARLA S.ROSENMANMD
The histologic sections revealed pseudoepitheliomatous hyperplasia overlying a prominent dermal granulomatous infiltrate with multinucleated giant cells. Clusters of neutrophils, along with lymphocytes, plasma cells, and eosinophils were also present. Dark brown, thick-walled, spherical spores were identified inside multinucleated giant cells and free in the tissue. Analyses under periodic acid–Schiff and Gomori methenamine silver stains highlighted these sclerotic bodies. Fonsecaea pedrosoi was confirmed by fungal culture as the etiologic agent. The patient was diagnosed as having chromoblastomycosis. Treatment was to include oral itraconazole, but the patient was subsequently lost to follow-up.
Verrucous Plaques on the Arm—Diagnosis. Arch Dermatol. 2009;145(2):195-200. doi:10.1001/archdermatol.2008.578-b