The clinico‐epidemiological characteristics and therapeutic experience of 152 patients with cutaneous sporotrichosis: a 10‐year retrospective study from India

Abstract

Background Cutaneous sporotrichosis, a subcutaneous mycosis because of Sporothrix schenckii, is sporadic worldwide with local hyperendemic pockets. Objectives To study clinico-epidemiological and therapeutic aspects of sporotrichosis in our clinic. Methods We retrospectively analyzed medical records of 152 (M:F 52:100) patients with cutaneous sporotrichosis managed during 2010-2019. Results All patients were involved in agricultural activities, and 63.2% were aged 21-60 years. Women outnumbered men by nearly two times. Fixed and lymphocutaneous sporotrichosis occurred in 54.6% and 43.4% patients, respectively. Only 2% of patients had multifocal sporotrichosis. Only 48% of patients imputed their disease to prior injuries. Extremities, upper in 53.9% and lower in 21% of patients, were mostly involved. Scrotum involvement in one patient was unusual. A mixed inflammatory infiltrate in 38.7%, chronic granuloma formation in 35%, and presence of spores in 48.9% biopsies was noted. S. schenckii grew on Sabouraud's dextrose agar in 40.2% of cases. Treatment with saturated solution of potassium iodide was curative in 76.8% patients, and lesions healed in 2-9 months (average 5.2 months). Metallic taste was experienced by 42.9% of patients. Itraconazole therapy was safe and effective in seven patients, and the response was better when combined with SSKI compared to either drug used alone. Conclusion Cutaneous sporotrichosis mostly affects persons during active years of life. The injuries predisposing to infection are mostly forgotten. Both fixed and lymphocutaneous sporotrichosis involving extremities remain common forms. SSKI alone or in combination with itraconazole is safe and effective treatment. Itraconazole is preferable in patients having preexisting hypothyroidism or intolerance to SSKI.

Retrospective analysis of 71 patients with cutaneous sporotrichosis

“…However, there are considerable regional variations between men and women. Women have approximately twice the morbidity as men in India due to greater participation in agricultural activities 11 . Men have higher morbidity than women in South Africa, with a male‐to‐female ratio of 3:1, this is because they often engage in outdoor activities and mining labour 12 .…”

Human sporotrichosis: recommendations from the Brazilian Society of Dermatology for the clinical, diagnostic and therapeutic management

“…phagocytosis and biofilm inhibition in the yeast-like and filamentous phases. 85 , 86 The anti-inflammatory effect in vivo seems to be related to cytokine regulation, with increased levels of IL-10 and IL-35. 87 It is likely that the anti-inflammatory and immunomodulatory effects are responsible for faster clinical improvement than with itraconazole or terbinafine.…”

Clinical Epidemiology of Sporotrichosis in Jilin Province, China (1990–2019): A Series of 4969 Cases

“…Trauma is usually needed for fungus entry. 2 Sharma et al 29 reported 152 sporotrichosis cases, 48% of which had a history of trauma. Comparatively, among patients who visited our hospital, 26.4% reported a definite history of trauma (stab wounds by reed, corn stalk, or wood).…”