Cutaneous sporotrichosis: Unusual clinical presentations.

Three unusual clinical forms of sporotrichosis described in this paper will be a primer for the clinicians for an early diagnosis and treatment, especially in its unusual presentations. Case 1, a 52-year-old man, developed sporotrichosis over pre-existing facial nodulo-ulcerative basal cell carcinoma of seven-year duration, due to its contamination perhaps from topical herbal pastes and lymphocutaneous sporotrichosis over right hand/forearm from facial lesion/herbal paste. Case 2, a 25-year-old woman, presented with disseminated systemic-cutaneous, osteoarticular and possibly pleural (effusion) sporotrichosis. There was no laboratory evidence of tuberculosis and treatment with anti-tuberculosis drugs (ATT) did not benefit. Both these cases were diagnosed by histopathology/culture of S. schenckii from tissue specimens. Case 3, a 20-year-old girl, had multiple intensely pruritic, nodular lesions over/around left knee of two-year duration. She was diagnosed clinically as a case of prurigo nodularis and histologically as cutaneous tuberculosis, albeit, other laboratory investigations and treatment with ATT did not support the diagnosis. All the three patients responded well to saturated solution of potassium iodide (SSKI) therapy. A high clinical suspicion is important in early diagnosis and treatment to prevent chronicity and morbidity in these patients. SSKI is fairly safe and effective when itraconazole is not affordable/ available.

A Case of Lymphocutaneous Sporotrichosis on the Infantile Face / 대한의진균학회지

Sporotrichosis is a chronic cutaneous fungal infection caused by Sporothrix (S.) schenckii. It is subdivided into three groups by clinical manifestation: lymphocutaneous, fixed cutaneous, disseminated sporotrichosis. Lymphocutaneous sporotrichosis is most common type and involves upper extremities usually. The incidence of lymphocutaneous sporotrichosis on the face is very low, especially in children. We report a case of lymphocutaneous sporotrichosis on face in a 10-month-old girl. The lesions represented linear three small erythematous papules on the right cheek. The fungal culture on Sabouraud's dextrose agar showed dark brown to black colored wrinkled colonies. The microscopic examination showed septated, branched mycelia and clustered conidia in slide culture of S. schenckii. The patient was treated with oral administration of potassium iodide and the lesions were cured completely.