title: Cutaneous blastomycosis. An imported case with good response to itraconazole.
abstract: BACKGROUND
  Blastomycosis is a subacute or chronic deep mycosis caused by a dimorphic fungus called Blastomyces dermatitidis, which generally produces a pulmonary form of the disease and, to a lesser extent, extra-pulmonary forms such as cutaneous, osteoarticular and genitourinary, among others. Cutaneous blastomycosis is the second clinical presentation in frequency. It is considered as primary when it begins by inoculation of the fungus due to traumas, and secondary when the lung fails to contain the infection.
  
  
  METHODS
  We present the case of a 57 year-old male who had a 5 year-history of an irregularly shaped verrucous infiltrative plaque related to and insect bite and posterior trauma due to the manipulation of the lesion. B. dermatitidis was identified using direct examination, stains, isolation in culture media, histopathology, and molecular studies. An antifungal susceptibility test was performed using method M38-A2 (CLSI). Clinical and mycological cure was achieved with itraconazole.
  
  
  CONCLUSIONS
  This cutaneous blastomycosis case acquired in the United States (Indianapolis) is rather interesting and looks quite similar to other mycoses such as coccidioidomycosis or sporotrichosis. The presented case shows one of the multiple issues concerning migration between neighboring countries.
authors.affiliation: Departamento de Micología, Mexico; Servicio de Dermatología del Hospital General de México, Mexico. Electronic address: a_bonifaz@yahoo.com.mx.
authors.forename: Alexandro
authors.initials: A
authors.lastname: Bonifaz
authors.affiliation: Servicio de Dermatología del Hospital General de México, Mexico.
authors.forename: Diana
authors.initials: D
authors.lastname: Morales
authors.affiliation: Servicio de Dermatología del Hospital General de México, Mexico.
authors.forename: Neredi
authors.initials: N
authors.lastname: Morales
authors.affiliation: Servicio de Dermatología del Hospital General de México, Mexico.
authors.forename: Patricia
authors.initials: P
authors.lastname: Mercadillo
authors.affiliation: Departamento de Microbiología, Facultad de Medicina, UANL, Monterrey, Mexico.
authors.forename: Gloria M
authors.initials: GM
authors.lastname: González
authors.affiliation: Laboratorio de Micología Médica, Departamento de Microbiología y Parasitología, Facultad de Medicina, UNAM, Mexico.
authors.forename: Francisca
authors.initials: F
authors.lastname: Hernández-Hernández
authors.affiliation: Departamento de Micología, Mexico; Servicio de Dermatología del Hospital General de México, Mexico.
authors.forename: Javier
authors.initials: J
authors.lastname: Araiza
authors.affiliation: Departamento de Micología, Mexico; Servicio de Dermatología del Hospital General de México, Mexico.
authors.forename: Denisse
authors.initials: D
authors.lastname: Vázquez-González
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D001759:Blastomycosis / Q000188:drug therapy*; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use*; D008297:Male; D008800:Mexico / Q000208:ethnology; D008875:Middle Aged; D012074:Remission Induction; D014171:Transients and Migrants
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole
keywords: Ajellomyces dermatitidis; Blastomicosis cutánea; Blastomyces dermatitidis; Cutaneous blastomycosis; Dimorphic; Dimórfico; Itraconazol; Itraconazole