Cutaneous sporotrichosis is a fungal infection caused by traumatic inoculation of Sporothrix. We aimed to study the clinical characteristics of human sporotrichosis, risk factors for infection, the yield of diagnostic methods and therapeutic response to standard clinical therapy. A cohort study of was performed. A total of 29 patients with clinical features suggestive of sporotrichosis were recruited within a one-year period from all public hospitals in Kedah, Malaysia. Majority were females (86%) who were housewives (69%). The most common comorbidities were diabetes mellitus (38%), hypertension (31%) and dyslipidaemia (21%), none was a significant risk factor for severity of infection. Mean duration of disease was 2±2 months. More than 2/3 of the patients (79%) had pet cats, 14(48%) recalled minor cat-inflicted trauma. Lymphocutaneous sporotrichosis (62%) was more common than fixed cutaneous type, affecting the upper limbs in 94%. Ulcerations and nodules were the main lesion morphology. Histopathology showed granulomatous inflammation in 72%, culture grew Sprorothrix in 55% and polymerase chain reaction (PCR) detected Sporothrix schenkii sensu stricto in 65%. Itraconazole was effective with 93% of patients achieving complete resolution with 4 months of therapy. Sporotrichosis in Malaysia remains endemic. Feline contact is the most important risk factor for infection. Diagnosis is best confirmed with tissue PCR while culture and histopathology are also useful. Sporothrix schenkii sensu stricto was the only species identified and itraconazole is an effective first line therapeutic agent.

Summary Tuberculosis (TB) is a serious communicable disease of major concern in endemic regions. Cutaneous tuberculosis (CTB), which accounts for less than 1% of all cases, can cause severe infection in susceptible patients. The diagnosis of CTB is challenging as it can present with a multitude of clinical presentations. The diagnosis must be supported by highly sensitive and specific investigations. This paper highlights the susceptibility of immunocompromised patients to the development of CTB and the challenges in making a diagnosis.
Tuberculosis, Cutaneous ; HIV Infections

Angiosarcoma is a rare, malignant vascular endothelium neoplasm with poor prognosis. Cutaneousangiosarcoma makes up a majority of its presentation. Diagnosis is often delayed due to the nature ofits clinical presentation. We report 3 cases of cutaneous angiosarcoma to focus on the importance ofbiopsy site selection in securing the histopathological diagnosis.

Elephantiasis nostras verrucosa occurs due to chronic lymphedema, characterized by cutaneous changes consisting of papillomatous, verrucous, and hyperkerototic lesions. Treatment of elephantiasis nostras verrucosa is challenging and results are often disappointing. We report our experience with a patient who was successfully treated with oral acitretin.