Systemic blastomycosis usually is fatal. In a review of the literature Martin and Smith1 noted a mortality of 92% in patients who had been followed for two years or longer. Cutaneous blastomycosis rarely causes death, but untreated lesions may be present for many years.
Since the synthesis of a group of compounds known as aromatic diamidines by Ashley and his co-workers2 in the course of their studies on trypanocidal drugs, a surprisingly large number of other therapeutic effects have been shown both in vitro and in vivo. The first hint that the aromatic diamidines might be fungistatic came from the studies of Elson3 who used one member of this group, "propamidine" (4,4'-diamidinodiphenyloxypropane hydrochloride) in several in vitro experiments with some of the organisms responsible for the superficial and deep mycoses. The experiments with Blastomyces dermatitidis showed effective fungistatic properties in dilutions as low as 0.075 mg. of
CURTIS AC, HARRELL ER. USE OF TWO STILBENE DERIVATIVES (DIETHYLSTILBESTROL AND STILBAMIDINE) IN TREATMENT OF BLASTOMYCOSIS. AMA Arch Derm Syphilol. 1952;66(6):676–690. doi:10.1001/archderm.1952.01530310014002
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