LB974 Blastomycosis-like pyoderma: A diagnosis of correlation

A 63-year-old fisherman presented for a chronic and progressive eruption, beginning on his right hand extending up arm over the past 8 years. He reported that he spent time in forests handled raw fish without gloves frequently; also recalled an inoculation injury while forest. The patient denied previous exposure to halogens. On examination, had multiple edematous verrucous plaques with crust elevated borders dorsal ventral aspects of upper extremity. clinical differential diagnosis included sporotrichosis, chromomycosis, atypical mycobacterial infection (particularly due M. marinum). Punch biopsy forearm lesion revealed pseudoepitheliomatous hyperplasia prominent intraepithelial abscesses surrounded by suppurative granulomas. These changes were limited half dermis; there was fibrosis lower dermis. tissue culture identified Staphylococcus aureus. While nonspecific isolation, each clinical, histopathologic, microbiologic features when correlated confirmed blastomycosis-like pyoderma (BLP). prescribed three-month course acitretin cefadroxil. Follow-up difficulty contacting after treatment. BLP is characterized pathologic, which are individually but permit this rare recalcitrant bacterial infection. Bacteria such as aureus, Streptococcus spp., Pseudomonas aeruginosa have been implicated. made based histopathologic findings, exclusion other diseases can cause similar vegetative deep fungal infections halogenoderma. Treatment modalities include oral topical antibiotics, acitretin, corticosteroids, curettage, cryotherapy, potassium iodide, laser therapy, surgical excision.