The article presents an analysis of published data on skin blastomycosis, as well as our own observations. Literature review describes clinical forms of blastomycosis (North American, South American, keloid, European) and focuses on the detailed study of North American blastomycosis, which is caused by Blastomyces dermatitidis. We have noted that this pathogenic agent is characterized by biphasic manifestation, which allowed us to differentiate it from other pathogenic fungi. We described a pathognomonic clinical sign of the Gilchrist disease, a raised bluish-purple or maroon periphery with small yellowish spots. The article reports a case of the North American blastomycosis in a 51-year-old male. The aforementioned case of cutaneous blastomycosis should remind dermatologists of clinical features and methods of microbiological identification of the pathogen and facilitate the differential diagnosis of this rare skin pathology.