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October 2007

Beefy Red Plaque in the Popliteal Fossa—Diagnosis

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Copyright 2007 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2007

Arch Dermatol. 2007;143(10):1323-1328. doi:10.1001/archderm.143.10.1323-h

At the initial visit, findings from the potassium hydroxide touch-preparation smear from the right popliteal fossa plaque revealed large 5- to 15-μm-diameter refractile ovoid to circular yeast forms with occasional broad-based budding. Histologic examination results from the shave biopsy specimen revealed marked pseudoepitheliomatous hyperplasia, scattered intraepidermal and intradermal neutrophilic microabscesses, marked epidermal spongiosis, and an underlying suppurative chronic inflammatory infiltrate with multinucleated giant and plasma cells. Scattered broad-based budding yeast forms were seen within the inflammatory infiltrate. The periodic acid–Schiff stain was positive for the presence of fungus.