A seventy-six-year-old man from New Jersey developed multiple pustular lesions on his face, trunk, and extremities. These rapidly assumed a crusted appearance, and were proven, by culture and histopathology, to be North American blastomycosis. The patient was successfully treated with amphotericin B. Complement fixation studies paralleled clinical improvement and laboratory studies revealed impaired white cell function. It is postulated that the organism was first encountered fifty years earlier when the patient worked in an area in which blastomycosis was endemic.