Symptoms:

Skin symptoms occur in about 80% of people whose blastomycosis infection spreads beyond their lung.

Papules, pustules, or nodules are most frequently found on exposed body areas.

• They may look like warts or ulcers.
• They are usually painless.
• They may vary from gray to violet in color.

The pustules may:

• Form ulcers
• Bleed easily
• Occur in the nose or mouth

Over time, these skin lesions can lead to scarring and loss of skin color (pigment).

Signs and tests:

The infection is diagnosed by identifying the fungus in a culture taken from a skin lesion. This usually requires a skin biopsy.

Treatment:

This infection is treated with antifungal drugs such as amphotericin B, itraconazole, ketoconazole, or fluconazole. Either oral or intravenous (directly in the vein) drugs are used, depending on the form and stage of the disease.

Expectations (prognosis):

What happens depends on the form of blastomycosis and the individual's immune system. In immunosuppressed individuals, long-term treatment may be required to prevent symptoms from coming back.

Complications:

• Abscesses (pockets of pus)
• Additional (secondary) skin infection caused by bacteria
• Complications related to medications (for instance, amphotericin B can have severely unpleasant side effects)
• Spontaneously draining nodules

Calling your health care provider:

Some of the skin problems caused by blastomycosis can be similar to skin problems caused by other illnesses. Tell your doctor if you develop any worrisome skin problems.