One Picture One Diagnosis-11

Deba P Sarma, MD Omaha

Diagnosis: Chromomycosis

In skin lesions, the cigar-colored fungi are easily seen in hematoxylin and eosin–stained sections. No special stains are needed. Usual finding is a pseudoepitheliomatous hyperplasia of the epidermis with a diffuse, lymphomononuclear inflammatory infiltrate in the dermis. Tissue response to the fungus is typically mixed granulomatous and neutrophilic. Abscesses, granulomas, granulomatous reactions, and abscesses surrounded by a granulomatous reaction with giant cells seen. Fungal cells may be single, 2-celled, or multiple-celled resulting from multiplication by septation rather than budding

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