Dysmorphic Trichophyton rubrum Mimicking Blastomycosis

We will describe a 62 year old immunocompromised, diabetic, male patient who presented with several cutaneous lesions. The patient was 4 years post-nephrectomy due to renal cell carcinoma and 6 months post-renal transplantation at time of presentation. Initial clinical impression was thought to be deep fungal infection or metastatic carcinoma. Trichophyton rubrum with a dysmorphic morphology simulating blastomycosis was ultimately diagnosed.