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Figure 1. Cutaneous Lesions of Disseminated Candidiasis.
Erythematous papules with pale centers are present on the arm of a 13-year-old boy with neutropenia and Ewing's sarcoma. Blood cultures grew Candida parapsilosis and C. lusitania. The lesions were widespread and numbered in the hundreds. The patient presented with the skin lesions; myalgias and eye pain followed. The pustule is the cutaneous sign of disseminated candidiasis in a host capable of leukocytosis. In the absence of circulating neutrophils, pustules do not appear on the skin; as the white-cell count recovers, the lesions may become pustular even as the infection is being treated.
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