Cutaneous sporotrichosis of face: Polymorphism and reactivation after intralesional triamcinolone

Sharma, Nand Lal; Mehta, Karan; Mahajan, Vikram K.; Kanga, Anil; Sharma, Vikas; Tegta, Geeta Ram

doi:10.4103/0378-6323.32745

Cited by 15 publications

(16 citation statements)

References 8 publications

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“…Apart from classic cutaneous sporotrichosis uncommon lesional morphology mimicking facial cellulitis, erysipelas, rosacea, sarcoidosis, BCC, keratoacanthoma, soft tissue sarcoma and pyoderma gangrenosum has been described. [13] To the best of our knowledge intensely pruritic, nodular prurigo-like lesions as seen in our case 3 are not reported hitherto in the literature. Trauma from repeated scratching apparently contributed in formation and spread of new lesions due to autoinoculation along excoriations resulting in linear and bizarre configuration.…”

Section: Discussionmentioning

confidence: 51%

Cutaneous sporotrichosis: Unusual clinical presentations

Mahajan¹,

Sharma²,

Shanker³

et al. 2010

Indian J Dermatol Venereol Leprol

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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.

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Section: Discussionmentioning

confidence: 51%

Cutaneous sporotrichosis: Unusual clinical presentations

Mahajan¹,

Sharma²,

Shanker³

et al. 2010

Indian J Dermatol Venereol Leprol

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“…The lesions are asymptomatic, erythematous, papules, papulopustules, nodules, or verrucous plaques and occasionally nonhealing ulcers or small abscesses. The lesions may resemble keratoacanthoma, facial cellulitis, pyoderma gangrenosum, prurigo nodularis, soft tissue sarcoma, basal cell carcinoma, erysipeloid, or rosacea [ 14 , 36 , 37 ]. This form is considered to occur usually among hosts having high resistance wherein minimal lesions may subside spontaneously or persist exceptionally if not treated, and responds better to treatment [ 15 , 38 ].…”

Section: Clinical Presentationsmentioning

confidence: 99%

“…Although treatment is prolonged and expensive, complete recovery without scarring is expected in cutaneous sporotrichosis following appropriate therapy. However, compromised pulmonary functions in pulmonary disease, severe disability from chronic osteoarticular sporotrichosis, or occasional scarring may result [ 36 , 47 , 66 ]. Patients with immunosuppression usually require life-long suppressive therapy.…”

Section: Treatment Optionsmentioning

confidence: 99%

Sporotrichosis: An Overview and Therapeutic Options

Mahajan¹

2014

Dermatology Research and Practice

177

194

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Sporotrichosis is a chronic granulomatous mycotic infection caused by Sporothrix schenckii, a common saprophyte of soil, decaying wood, hay, and sphagnum moss, that is endemic in tropical/subtropical areas. The recent phylogenetic studies have delineated the geographic distribution of multiple distinct Sporothrix species causing sporotrichosis. It characteristically involves the skin and subcutaneous tissue following traumatic inoculation of the pathogen. After a variable incubation period, progressively enlarging papulo-nodule at the inoculation site develops that may ulcerate (fixed cutaneous sporotrichosis) or multiple nodules appear proximally along lymphatics (lymphocutaneous sporotrichosis). Osteoarticular sporotrichosis or primary pulmonary sporotrichosis are rare and occur from direct inoculation or inhalation of conidia, respectively. Disseminated cutaneous sporotrichosis or involvement of multiple visceral organs, particularly the central nervous system, occurs most commonly in persons with immunosuppression. Saturated solution of potassium iodide remains a first line treatment choice for uncomplicated cutaneous sporotrichosis in resource poor countries but itraconazole is currently used/recommended for the treatment of all forms of sporotrichosis. Terbinafine has been observed to be effective in the treatment of cutaneous sporotrichosis. Amphotericin B is used initially for the treatment of severe, systemic disease, during pregnancy and in immunosuppressed patients until recovery, then followed by itraconazole for the rest of the therapy.

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“…Fluorescentlabeled antibodies staining sometimes helps to recognize the cigar shaped yeast forms. 80,81 Itraconazole, terbinafine, potassium iodide and local hyperthermia can be effective for treating sporotrichosis. Itraconazole is the drug of choice for cutaneous disease.…”

Section: Accepted Manuscriptmentioning

confidence: 99%