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Oct 2012

Pustules and Sinus Tracts Involving the Right Arm of an Elderly Patient—Diagnosis

Arch Dermatol. 2012;148(10):1200. doi:10.1001/archderm.148.10.1200-a

The histopathologic findings from a pustule specimen from the right arm showed a dense dermal neutrophilic infiltrate consistent with an abscess (Figure 2). Grocott methenamine silver (GMS) staining was performed and showed a few small budding yeast fragments (Figure 3). There was no overt evidence of herpes virus infection. Tissue culture yielded Scedosporium species. The histopathologic features were consistent with a diagnosis of eumycetoma. The patient was treated with intravenous voriconazole, and in 4 weeks he had a marked decrease in limb girth, tenderness, and erythema with no signs of active infection.