1 Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
2 Pathology, Toronto General Hospital, Toronto, ON, Canada.
J Cutan Med Surg. 2018 Sep/Oct;22(5):519-521. doi: 10.1177/1203475418760460. Epub 2018 Feb 28.
Blastomyces dermatitidis is typically contracted through inhalation of the dimorphic conidia, resulting in pulmonary infection as well as extrapulmonary disease through hematogenous spread. Blastomycosis is considered one of the great mimickers in medicine, with verrucous cutaneous blastomycosis resembling skin malignancy and B dermatitidis pulmonary infections often confused with lung cancer. Cutaneous blastomycosis can also often mimic pyoderma gangrenosum and should be considered in the differential diagnosis in any suspected case. This case involves a cutaneous blastomycosis lesion of the leg that was initially diagnosed as squamous cell carcinoma, which was excised. Within a month, the atypical lesion recurred in the area and was unresponsive to antibiotic therapy, rapidly progressing in size and inflammation. We discuss the eventual diagnosis of this blastomycosis infection and the importance of ruling out cutaneous blastomycosis when managing pyoderma gangrenosum.
皮炎芽生菌通常通过吸入二态分生孢子而感染，导致肺部感染以及血源性播散引起的肺外疾病。芽生菌病被认为是医学上的一种重要的模拟疾病，疣状皮肤芽生菌病类似于皮肤恶性肿瘤，而 B 皮炎芽生菌肺部感染常与肺癌混淆。皮肤芽生菌病也常类似于坏疽性脓皮病，在任何疑似病例中都应考虑进行鉴别诊断。本病例涉及腿部皮肤芽生菌病病变，最初被诊断为鳞状细胞癌并进行了切除。在一个月内，该非典型病变在该区域复发，对抗生素治疗无反应，且大小和炎症迅速进展。我们讨论了最终的芽生菌感染诊断以及在治疗坏疽性脓皮病时排除皮肤芽生菌病的重要性。
