Background: The immune response against Blastomyces dermatiditis is less clear than that of Histoplasma spp. or Coccidioides spp. This study was done to evaluate the cellular immune host response in patients with ulcerative and verrucous skin lesions. Methods: This study was conducted on 50 patient attended Al-Kadhymiah Teaching Hospital/Dermatology Dep. in Baghdad (2009Baghdad ( -2010. After processing of skin samples, all cases were studied for various lymphocyte subtypes by using direct dual immunofluorescence staining method. Independent sample t-test was used to make a comparison between groups and p-value <0.05 was considered significant. Results: Histopathological examination showed 4 biopsies of skin lesions were Blastomyces dermatitidis positive and 46 biopsies were negative, two cases were ulcerative and two were verrocous . According to this classification, the total cell counts, CD3+ cells was found statistically different (p=0.034). Plasma cell (CD19), T-helper (CD4) and T-cytotoxic (CD8) also were significant when p values were (p=0.046), (p=0.020) and (p=0.018) respectively. According to the type of lesion whether it is ulcerative or verrocous, CD3+, CD4+, CD8+ and CD19+ counts for each type were significant when, P value were (p≤0.001, p=0.003, p=0.026 and 0.050) respectively. However, there were no significant difference was seen for these cells (p>0.05) among negative lesions.
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