Disseminated cutaneous sporotrichosis: unusual presentation in an alcoholic patient

Abstract

Sporotrichosis is an implantation mycosis highly prevalent in Brazil, associated with soil activities and contact with infected animals. It has numerous clinical manifestations and its disseminated cutaneous form is uncommon, found in approximately 4% of cases and usually related to immunosuppressive conditions. We report an alcoholic 56-year-old male patient with no other comorbidities, presenting with multiple cutaneous nodules and ulcers. The patient was diagnosed with disseminated cutaneous sporotrichosis based on the isolation and identification of Sporothrix spp. The patient was initially treated with amphotericin B with satisfactory results and then with itraconazole.

Figure 1. A) erythematous and ulcerated nodules, ulcers with well-framed borders, purulent and crusted lesions on the face and the scalp; B) well limited ulcer with well-framed border on the left arm; C) erythematous and ulcerated nodules scattered on the skin.

Figure 2. A) obverse of culture - cream color with blackened halo; B) presence of ovoid, round and cigar-shaped structures (PAS 400 x); C) granulomatous dermatitis with multinucleated giant cells (400 x)

Figure 3. Substantial improvement of lesions after treatment.