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Arch Dermatol. 2008;144(7):933-938.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Diagnosis: Cutaneous coccidioidomycosis.

MICROSCOPIC, LABORATORY, AND RADIOGRAPHIC FINDINGS AND CLINICAL COURSE

Histopathologic examination showed pseudoepitheliomatous hyperplasia of the epidermis and multiple granulomas in the dermis, with a surrounding mixed cell infiltrate. Thick-walled spherules with endospore formation and several of the multinucleate giant cells were present within the granulomas. Complement fixation tests were strongly positive for fungal antibodies, with a Coccidioides titer of 1:16. There was no evidence of lung involvement on chest x-ray films. Fungal cultures of the skin yielded Coccidioides immitis. After the biopsy results were received, fluconazole therapy (400 mg/d) was initiated, resulting in flattening of the nodules over a period of 5 months.

DISCUSSION

Coccidioidomycosis, which was first described as a definitive disease by Posada¹ in 1892, is caused by the dimorphic soil fungus C immitis. It is endemic in the San Joaquin Valley of California and in northern Mexico as well as in Central and South America. Reported cases are usually isolated and sporadic.² Men have . . . [Full Text of this Article]

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Arch Dermatol. 2008;144(7):933-938.
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