ID

Cutaneous Sporotrichosis

search

Cutaneous Sporotrichosis, Sporotrichosis, Sporothrix schenckii, Rose Gardener's Disease

  • See Also
  1. Nodular Lymphangitis
  • Pathophysiology
  1. Caused by Saprophytic, Dimorphic fungus (Sporothrix schenckii)
  2. Prototypal example of Nodular Lymphangitis
  • Risk Factors
  • Exposures
  1. Soil or plant debris
  2. Thorns
  3. Sphagnum moss
  4. Timber
  5. Animal Bites or scratches
  • Signs
  1. Primary lesion after 1-12 week incubation
    1. Small, painless pink nodular lesions develop at site of inoculation
  2. Secondary lesions
    1. Erythematous Papules, Nodules develop up lymph chain
    2. Lesions ulcerate and drain clear serous fluid
  3. Other findings
    1. Rarely fever or regional adenopathy occur
    2. Extensive disseminated skin involvement without treatment
  • Differential Diagnosis
  1. See Nodular Lymphangitis
  • Labs
  1. Routine fluid culture negative
  2. Culture of biopsied tissue shows saprophytic fungi
  • Management
  1. Apply warm compresses for 40 to 60 minutes per day
  2. Antifungal for 2 months after lesion resolution
    1. Itraconazole 200 mg orally daily (preferred)
    2. Terbinafine (Lamisil) 250 mg orally twice daily
    3. Saturated Solution Potassium iodide (SSKI)
      1. Used in under-resourced regions
      2. Start 5 drops orally three times daily
      3. Titrated to 40-50 drops three times daily
  • References
  1. Kauffman (1995) Clin Infect Dis 21:981-5 [PubMed]
  2. Mahajan (2014) Dermatol Res Pract 2014:272376 +PMID: 25614735 [PubMed]
  3. Tobin (2001) Am Fam Physician 63(2):326-32 [PubMed]