Is Cutaneous Blastomycosis a Systemic Disease?

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Abstract
Within recent years a new concept of the pathogenesis of cutaneous blastomycosis has been introduced. Simply stated, it postulates that cutaneous blastomycosis is not a primary inoculation process as previously assumed but rather a manifestation of a systemic disease, the internal focus, obvious or undetectable, being in the lungs. The following case report will serve as a basis for exploring this hypothesis. REPORT OF A CASE A white man, age 25 years, from Sutton, N. D., was first seen on July 14, 1954, complaining of a chronic ulceration on the left great toe. In January, 1953, during a basket-ball game, a blister first appeared at this site. He had left his own basketball shoes at home and, while in the locker room, had borrowed another pair for the game. The owner of the shoes was unknown. The basketball shoes were not of the patient's size, and

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