Sporotrichosis in Adult
The lesions of sporotrichosis may present in 3 different patterns.
- Lymphocutaneous or sporotrichoid pattern – 80% of cases
- Fixed cutaneous – occurs in endemic areas with prior exposure
- Disseminated cutaneous – occurs with systemic involvement
Thorny plants, such as barberry and rose bushes, are the most common source of cutaneous inoculation of sporotrichosis. Other plant exposures include sphagnum moss, straw, hay, soil, and mine timbers. Occupational exposures include farmers, florists, gardeners, and forestry workers. Outside the United States, sporotrichosis outbreaks have been associated with infected cats. Untreated cutaneous sporotrichosis usually waxes and wanes over months to years without systemic manifestations.
B42.9 – Sporotrichosis, unspecified
42094007 – Sporotrichosis
- Mycobacterium marinum also causes a lymphangitic pattern on the extremity and has a similar pattern of red nodules.
- Cellulitis or erysipelas
- The typical pattern of lymphangitic spread can suggest herpes virus infections (HSV and zoster).
- Cat-scratch disease
- Superficial thrombophlebitis
- Other infections such as blastomycosis, coccidioidomycosis, nocardiosis, tularemia, cutaneous tuberculosis, leishmaniasis (Old World and New World), and actinomycosis may have a similar lymphangitic spread from cutaneous inoculation. Exposure and travel history are key for diagnosis.
- Sarcoidosis rarely ulcerates or spreads along lymphatics.
- Cutaneous lymphoma may have associated fevers and weight loss.
- Bacterial abscess has an acute onset.
- Pyoderma gangrenosum bleeds easily and appears vascular.
- Vasculitis does not usually have an exophytic growth pattern.
- Foreign body reaction to sea urchin spines or barnacles
- Halogenoderma (bromoderma, iododerma)