II. Etiology
III. Pathophysiology
- See Blastomycosis
- Direct contact of non-intact skin with contaminated soil or decomposing timber
IV. Symptoms
- Painful facial lesions (Pustules, ulcers or wart-type lesions)
V. Signs
- Distribution: Face (esp. eyebrows)
- Verrucous form
- Starts as Papule or Pustule with slow enlargement
- Later, the lesion forms crust with irregular borders
- Secondary Subcutaneous Nodules and abscesses may drain pus
- Ulcerative form
- Ulcerated lesion with sharp border
- Friable red granulation tissue at ulcer base may bleed easily
VI. Diagnosis
- Microscopy of purulent discharge with Potassium Hydroxide or Calcofluor stain
- Skin biopsy
VII. Differential Diagnosis
- Furuncle
- Contagious Ecthyma (Orf)
- Pyogenic Granuloma
- Squamous Cell Carcinoma
VIII. Management
- See Blastomycosis