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| Fig. 32.6 Blastomycosis. Classic verrucous plaques located on the forehead and eyelid. (Courtesy of the teaching files of Fitzsimons Army Medical Center.) |
The most characteristic cutaneous presentation is a single (or multiple) crusted, verrucous plaque on exposed skin (face, hands, arms) with color variation from gray to violet (Fig. 32-6). Microabscesses can form, and pus exudes when the crust is lifted off. As the plaque progresses, there is central clearing. Ulcerative lesions are a less common cutaneous presentation. Cutaneous involvement leads to the correct diagnosis in most cases.
