Leukocytoclastic Vasculitis Caused by Disseminated Cutaneous Sporotrichosis: A Case Report and Review of the Literature

Abstract

Cutaneous leukocytoclastic vasculitis (CLV) is a vasculitis that involves mainly small blood vessels in the skin. CLV has different causes (drugs, infections, or neoplastic or systemic inflammatory diseases). Sporotrichosis has rarely been associated with CLV. We report a case of disseminated cutaneous sporotrichosis caused by microorganisms in the Sporothrix clade in a Chinese woman with a tuberculous peritonitis history. Her lesions included many ulcers with crusts on the limbs. A skin biopsy yielded a histologic diagnosis of leukocytoclastic vasculitis. Periodic acid-Schiff and Grocott methenamine silver stains revealed numerous round-to-oval, thick-walled yeast cells in the necrotic tissue of the dermis. Mycological cultures grew pure dark brown wrinkled and villous fungus colonies morphologically and microscopic characteristics suggestive of the pathogenic Sporothrix clade which was followed confirmed as Sporothrix globosa (S. globosa) by the PCR method and sequencing based on calmodulin gene. Although infrequently, Sporothrix clade may cause CLV and should be considered in its differential diagnosis.