Abstract Blastomycosis is an uncommon fungal infection caused by Blastomyces species, resulting in pyogranulomatous type of reaction. It is predominantly associated with pulmonary involvement, wherein cutaneous manifestation is secondary. Primary cutaneous blastomycosis (PCB) is a rare presentation, more so in nonendemic countries like India. Here we report a case of PCB in a 69-year-old male presenting as an ulceroproliferative lesion at nasolabial fold, clinically diagnosed as basal cell carcinoma. However, histopathology of the lesion showed broad-based budding yeasts of Blastomyces. Since the pulmonary involvement was absent, the final diagnosis of PCB was rendered. The present case thus assumes importance as histopathology in the absence of culture proved to be a pivotal tool to diagnose the rare fungal infections like PCB in clinically unsuspected cases.
Azad Singh Singroha (Fri,) studied this question.
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