Fig. 2.

Biopsy findings on day +3 A) Superficial skin from the foot. There is marked hyperkeratosis and acanthosis with a moderate perivascular to interstitial mixed inflammatory infiltrate within the outer dermis. Hematoxylin and eosin stain. Bar=20 µm. B) Superficial skin from the foot, further magnification. Mixed perivascular to interstitial inflammation is composed of many neutrophils, fewer macrophages, eosinophils, and lymphocytes and plasma cells, and occasional gray-brown to negative profiles of fungal elements are seen. The wall of an artery is asymmetrically infiltrated with inflammatory cells. Hematoxylin and eosin stain. Bar=20 µm. C) Superficial skin from the foot. Myriad gray (silver) staining fungal elements, including branching, irregularly septate, hyphae with non-parallel walls and with terminal bulbous morphology are seen infiltrating host tissue elements staining green. Grocott's methenamine silver (GMS). Bar=20 µm. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article).