LAUSR

INTRODUCTION Blastomycosis is one of three major thermally dimorphic mycoses endemic to North America, particularly so in the Mississippi and Ohio River valleys, as well as in the Great Lakes area. The organism responsible for the disease, Blastomycosis dermatitidis, lives as a benign mold in the environment and transforms to a pathologic yeast after inoculation. Infection is typically acquired from inhalation of the organism but can also occur from direct inoculation after trauma. Those who engage in work outdoors are most likely to be infected. Blastomycosis has a predilection for the lung, and the pathophysiology typically involves a primary pulmonary infection. Cutaneous manifestations of pulmonary blastomycosis are common and are reported in up to 60% of patients. However, primary cutaneous blastomycosis is much less frequently reported. We present the case of primary cutaneous blastomycosis in a middle-aged woman in the Midwest US, who had waxed her eyebrows one week prior to lesion development. Notably, the patient had developed a wax burn following the treatment, a known risk of eyebrow waxing, with resultant hypopigmentation in the treated area. The diagnosis of blastomycosis was made after a high clinical index of suspicion and confirmed after twenty six days with positive tissue culture.