Sporotrichosis is a mycosis caused by a saprophytic dimorphic fungus named Sporothrix schenckii. Infections occur following traumatic inoculation of fungus from plants and infected cat bites and scratches. We report a case of a farmer who presented with a solitary subcutaneous nodule initially diagnosed as a soft tissue tumour. A history of agricultural activity and feline contact should draw the clinician's attention to sporotrichosis, as the diagnosis can be easily missed in atypical cases. The diagnosis, microbiology and management of the case are discussed.
Biopsy, Needle ; Diagnosis, Differential ; Soft Tissue Neoplasms/*diagnosis ; Sporothrix/isolation & purification ; Sporotrichosis/*diagnosis ; Sporotrichosis/microbiology ; Sporotrichosis/surgery

Sporotrichosis is an infection of worldwide distribution caused by the fungal organiam sporotrichum schenckii. The disease is usually of the primary cutaneous variety with involvement of regionaI lymphatics, although dissemination may occur. A case of lymphatic type of Syorotrichosis affecting 33 years old, barber, who has been suffering from painless multiple nodules on right hand 4 forearm, is presented. The skin lesions developed about 3months ago, and increased sise and numbers of the lesion insidiously. Diagnosis was confirmed by characterietic clinical, mycological, histopathological studies He was treated with potassium iodide and there was markedly improved.
Adult ; Diagnosis ; Forearm ; Hand ; Humans ; Potassium Iodide ; Skin ; Sporothrix ; Sporotrichosis*

Non-lymphatic sporotrichosis is more difficult in diagnosis, lower in incidence and more variable in clinical picture than the classical lymphatic one. A case of non-lymphatic type affecting a female baby aged 2 months is presented, The patient has been suffering from the shallow ulcerated, crusted impetiginous lesian on the cheek area just below the right eye. The lesion has developed progreasively since about 1 month after birth. Clinically, its diagnosis was not easy, but was confirmed by culture on Sabouraud's media. It is thought that the age of initial onset in this case we experienced, is the lowest in recorded Korean literature.
Cheek ; Diagnosis ; Female ; Humans ; Incidence ; Parturition ; Sporotrichosis ; Ulcer

Fixed cutaneous sporotrichosis is a differential diagnosis that can be considered in diabetic patients who present with a poorly healing ulcer. Although its prevalence is low, it can occur in patients with immunocompromised status. Here we report a case of a 70-year-old man with diabetes mellitus who presented with a 1-month history of an unhealed ulcer over the tip of his left middle finger. He experienced a cat bite over his left middle finger 1 month prior to the appearance of the lesion. A skin biopsy revealed the presence of Sporothrix schenckii. Oral itraconazole 200 mg twice daily was started empirically and the patient showed marked improvement in the skin lesion after 2 months of therapy.
Aged* ; Animals ; Biopsy ; Cats ; Diabetes Mellitus ; Diagnosis, Differential ; Fingers* ; Humans ; Itraconazole ; Prevalence ; Skin ; Sporothrix ; Sporotrichosis ; Ulcer*

We experienced 3 cases of sporotrichosis confined to the face. They were lymphatic type, pustular type and fixed ulcerative type of cutaneous sporotrichosis respectively. Two types of them except the lymphatic type were very difficult to be diagnosed correctly with clinical features. So, we reviewed the types of sporotrichosis and the problems in establishing the diagnosis. 3 cases are as follows: Case l. A 57 years old female second hand dealer had a ulceration measuring 2-2cm in diameter on the right dorsum of the nose after injuring with sharp rusty iron material. Soon after ulceration healed, 5 beaded nodules measuring 0.5-1cm in diameter newly developed on the right side of the maxillary area. Case II. A 55 years old female house wife had a suppurated ulcer with serous exudate, which looked like impetigenous lesions, on the left mandibular area, without any apparent trauma history. Case III. A 52 years old female had a rice grain sized papule, which was grown slowly in size, on the left maxillary area without any apparent trauma history. Skin graft was performed after excision of the nodule, because it was diagnosed as skin cancer at a local clinic. A large ulceration with necrosis of the tissues developed on the very site of skin graft performed, accompanied by a bean sized nodule below the ulceration.
Edible Grain ; Diagnosis ; Exudates and Transudates ; Female ; Hand ; Humans ; Iron ; Middle Aged ; Necrosis ; Nose ; Skin ; Skin Neoplasms ; Sporotrichosis* ; Spouses ; Transplants ; Ulcer

Sporotrichosis is a chronic infection that follows accidental implantation of the fungus Sporothrix schenckii into the skin. The infection begins with skin trauma under conditions when conidia may be present. A 48-year-old woman presented with a 5-year history of an 8X 12 cm sized, centrally depressed, erythematous plaque on the left wrist. She had been treated with antifungal agents at an other hospital for about 6 months but there was no improvement. The histopathological findings showed an infiltration of mononuclear cells and tuberculoid structures on the whole dermis and subcutis. According to the histopathological findings and clinical manifestations, she was diagnosed as having lupus vulgaris. There was much improvement of the lesion after antituberculous therapy. However, 2 months later she developed asymptomatic multiple erythematous papules around the lesion of lupus vulgaris and along the lymphatic drainage of the left arm. The histopathological findings of the newly developed lesion showed a granulomatous reaction and an infiltrate of acute and chronic inflammatory cells. Moist and creamy colonies were changed into brown-to-black ones with a leathery appearance with age. This appearance and clinical manifestations confirmed the diagnosis of lymphocutaneous sporotrichosis. This clinical appearance reflects that the sporotrichosis developed on the ulcerative lesion or biopsy site of lupus vulgaris.
Antifungal Agents ; Arm ; Biopsy ; Dermis ; Diagnosis ; Drainage ; Female ; Fungi ; Humans ; Lupus Vulgaris* ; Middle Aged ; Skin ; Spores, Fungal ; Sporothrix ; Sporotrichosis* ; Ulcer ; Wrist

Dermatomycoses are defined as the fungal infections of the skin including hair and nail. Generally, dermatomycoses are divided into superficial mycoses involving hair, nail and horny layer of the epidermis, and deep mycoses involving dermis and subcutis. Superficial mycoses described herein are dermatophytosis, candidiasis and Malassezia infection. Histopathologic findings of onychomycosis were a little more focused because of recently increased interest of its usefulness in making the diagnosis of onychomycosis and its causative fungi. Deep mycoses of the skin include primary or secondary dermal and/or subcutaneous fungal infections. Deep mycoses reported only in Korea were briefly described herein. Those are sporotrichosis, the most common primary cutaneous deep mycosis in Korea, and rare deep mycoses including chromoblastomycosis, phaeohyphomycosis, mycetoma, cutaneous paecillomycosis, aspergillosis, cryptococcosis, mucormycosis, systemic candidiasis, fusariomysosis, and trichophytic granuloma. Cutaneous protothecosis, a disease by achlorophilic algae, was also included because of its similarity of clinical and pathological findings with deep mycoses.
Aspergillosis ; Candidiasis ; Chromoblastomycosis ; Cryptococcosis ; Dermatomycoses* ; Dermis ; Diagnosis ; Epidermis ; Fungi ; Granuloma ; Hair ; Korea ; Malassezia ; Mucormycosis ; Mycetoma ; Mycoses ; Onychomycosis ; Phaeohyphomycosis ; Skin ; Sporotrichosis ; Tinea

Nocardia is aerobic gram positive bacteria, which is found in the soil. Cutaneous nocardiosis is divided into the primary skin infection and secondary infection due to systemic dissemination from the internal organ. Its clinical manifestations are mycetoma, lymphocutaneous infection and superficial infection, such as abscess or granuloma. In lymphocutaneous infection, it is important to make differential diagnosis with other diseases with sporotrichoid pattern, such as sporotrichosis, leishmaniasis and mycobacterial infection. In our case, 58 year old male who had history of chemotherapy due to lung cancer visited with granulomatous nodule on the left wrist, and following lymphangitis along the forearm for 2 months. Through a skin biopsy, culture, AFB stain and 16S rRNA gene sequencing, cutaneous nocardiosis by N. brasiliensis was diagnosed.
Abscess ; Biopsy ; Coinfection ; Diagnosis, Differential ; Forearm ; Genes, rRNA ; Gram-Positive Bacteria ; Granuloma ; Humans ; Leishmaniasis ; Lung ; Lung Neoplasms ; Lymphangitis ; Male ; Mycetoma ; Nocardia ; Nocardia Infections ; Skin ; Soil ; Sporotrichosis ; Wrist

Fungal diseases are grouped arbitarily into three broad categories based on the predominant location of infection within the body : superficial, cutaneous and subcutansous, and systemic. The Histopathologic features of more common fungal diseases were summarized in the table 1. and described in the text briefly. Herein described were superficial mycoses including dermatophytoses, pityriasis versicolor, cutaneous and subcutaneous including chromomycosis, rhinosporiodiosis, sporotrichosis, and systemic mycoses such as aspergillosis, candidiasis, cryptococcosis, fusariosis, zygomycosis and pneumocystosis. Characteristic and main histologic findings are granulomatous inflammation with respective organisms. The diagnosis of mycotic disease has four basic approach: clinical, mycologic, immunologivc and pathologic. Variety of host reaction are noted from non-specific reaction to granulomatous or mycetoma formation. Most important thing is mycological isolation and identification in the tissue. Multiple sections and special stains such as Gomori`s methenamine silver, Perioidic Acid Schiff, mucin stains, gram stains, acid fast stain, Giemsa stains are also very useful.
Aspergillosis ; Azure Stains ; Candidiasis ; Chromoblastomycosis ; Coloring Agents ; Cryptococcosis ; Diagnosis ; Fusariosis ; Inflammation ; Methenamine ; Mucins ; Mycetoma ; Mycoses ; Pneumonia, Pneumocystis ; Sporotrichosis ; Tinea ; Tinea Versicolor ; Zygomycosis

Clinical, mycoIogical, histopathological and epidemiological studies were done on 26 cases of cutaneous sporotrichosis which were found during the last 5 years, from 1967 to 1971, at the out-patient clinic of department of dermatology of this hospital, and the results obtained were as follows: 1. Twenty two cases of ascending lympho-cutaneous sporotrichosis with nodules, abscesses and chancres, 2 cases of gummatous, and one of each verrucoid and impctiginous types were found in total 26 cases of the disease. 2. All the patients encountered were inhabitants in rural area, and most of them were farmers (21 cases: 81%)and children living in that area. The sources of the infection were considered as soil and plants contaminated with the causative organism. 3. Age distribution of the disease revealed highest incidence in the fourth and fifth decades (l8 cases: 69%), who were active workers in Korean farm.4. Analysis of primary focus and affected region of the body revealed highest involvement over the upper extremities (19 cases: 73%), especially right hand (9 cases: 35%) and right arm (3 cases: 12%). 5. Better culture results were obtained as following order: the best with culture material aspirated from the closed abscess with sterile needIe and syringe, the second: with embeding the tissue from the lesion in the media exposing about half, and the third: with the materials obtained from the chancre and gumrnatous lesiors. 6. Histopathological findings revealed frequently the chronic inflammatory granulomatous tissue reaction with polymorphic cellularity and occasionally some vascularity or small multiple focal necrosis in the lesions. 7. Differential diagnosis of the disease should be considered with Lepromatous leprosy, Cysticercosis cutis, Tuberculosis of the skin and other mycobacteriosis of the skin particularly in this country. 8. In Korea the rate of the incidences of the disease was found to be the highest in Chonnam province by comparing the result obtained from this study with those of the report by others. In Chonnam province the disease were distributed almost all the counties but there were some different rates of the incidence of the disease between each counties. 9. Frequency of the disease among the total number of out-patients (12. 208) was 0.2% or 1 to 500 and showed relatively high incidence of the disease in the farm workers in Chonnam province, Korea. Clinical, mycoIogical, histopathological and epidemiological studies were done on 26 cases of cutaneous sporotrichosis which were found during the last 5 years, from 1967 to 1971, at the out-patient clinic of department of dermatology of this hospital, and the results obtained were as follows: 1. Twenty two cases of ascending lympho-cutaneous sporotrichosis with nodules, abscesses and chancres, 2 cases of gummatous, and one of each verrucoid and impctiginous types were found in total 26 cases of the disease. 2. All the patients encountered were inhabitants in rural area, and most of them were farmers (21 cases: 81%)and children living in that area. The sources of the infection were considered as soil and plants contaminated with the causative organism. 3. Age distribution of the disease revealed highest incidence in the fourth and fifth decades (l8 cases: 69%), who were active workers in Korean farm.4. Analysis of primary focus and affected region of the body revealed highest involvement over the upper extremities (19 cases: 73%), especially right hand (9 cases: 35%) and right arm (3 cases: 12%). 5. Better culture results were obtained as following order: the best with culture material aspirated from the closed abscess with sterile needIe and syringe, the second: with embeding the tissue from the lesion in the media exposing about half, and the third: with the materials obtained from the chancre and gumrnatous lesiors. 6. Histopathological findings revealed frequently the chronic inflammatory granulomatous tissue reaction with polymorphic cellularity and occasionally some vascularity or small multiple focal necrosis in the lesions. 7. Differential diagnosis of the disease should be considered with Lepromatous leprosy, Cysticercosis cutis, Tuberculosis of the skin and other mycobacteriosis of the skin particularly in this country. 8. In Korea the rate of the incidences of the disease was found to be the highest in Chonnam province by comparing the result obtained from this study with those of the report by others. In Chonnam province the disease were distributed almost all the counties but there were some different rates of the incidence of the disease between each counties. 9. Frequency of the disease among the total number of out-patients (12. 208) was 0.2% or 1 to 500 and showed relatively high incidence of the disease in the farm workers in Chonnam province, Korea.
Abscess ; Age Distribution ; Arm ; Chancre ; Child ; Cysticercosis ; Dermatology ; Diagnosis, Differential ; Epidemiologic Studies* ; Fisheries* ; Hand ; Humans ; Incidence ; Jeollanam-do ; Korea* ; Leprosy, Lepromatous ; Necrosis ; Outpatients ; Skin ; Soil ; Sporotrichosis* ; Syringes ; Tuberculosis ; Upper Extremity