This 14-year-old girl with leukemia and a total neurtophil count of 185 on day 21 of induction chemotherapy developed a tender rubbery plaque on her left leg. A biopsy showed filamentous fungi and the lesion was promptly excised the following morning. She developed 2 additional lesions the following day one of which demonstrated the same organism on touch prep. A source of infection was identified in her sinuses which were debrided. She received granulocyte colony stimulating factor with prompt recovery of her white blood cells and uncomplicated healing of her skin lesions. Throughout the episode she was afebrile and felt well.
1.5 X 3.5 cm tender indurated rectangular telangiectatic rubbery plaque with scattered purple crusts