PMC5602487_01
Dystrophic nail findings and circular purple papules on patient's lower extremity prior to therapy.
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fig1
The patient's primary care physician noticed this rash on the entire circumference of his upper extremities and extensor surface of his thighs bilaterally (Figure 1).
(a) Haematoxylin and eosin stain demonstrating granuloma formation. (b) Periodic acid-Schiff stain demonstrating fungal hyphae.
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fig2
A punch biopsy of the left medial forearm and left thigh lesion demonstrated a deep fungal infection and dense suppurative and granulomatous inflammation in the dermis centered around a follicle (Figure 2(a)), with budding yeast and hyphal forms within the follicle (Figure 2(b)), which was consistent with Majocchi's granuloma.