Global Dermatology Grand Rounds:
Case of the Month: August 1996
submitted by Dr. Carlos Abrego

September 1996



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History of Present Illness: A 50 year old male farm hand from Oaxaca, Mexico.

Past Medical History:

Physical Examination:

Four months ago nodules which subsequently abscessed and ulcerated appeared on the left forearm arm, which began distally and progressed proximally in a well-defined linear path. While the distal lesions became crusted and ulcerated, the more recent proximal lesions remained intact. The lesions were asymptomatic.

Laboratory Examinations: Isolated leukocytosis in the CBC and an increased sedimentation rate.

A direct smear of the exudate:

Histopathology (skin biopsy):

Fungal Culture (Sabouraud's medium):

Microscopic Examination of one of the fungal culture:

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