Sporotrichosis

• Schenck, 1898
• Lutz and Splendore, 1907

De Beurmann-Gougerot's disease.

Fungal infection of the cutis and subcutis caused by Sporotrix schenckii.

• Division:
  • Fixed cutaneous form
  • Lymphocutaneous form
  • Disseminated cutaneous form
  • Extracutaneous disseminated form
  • Note: in the disseminated and extracutaneous form, bones, joints, the lungs, meninges or other visceral organs are usually affected

• Occurring worldwide, but a rare disease in Europe
• Current especially in the tropics and subtropics
• Mexico: most common, deep fungal infection
• The infection is mainly observed in the rural population
• Common in immunocompromised individuals (alcohol abuse, diabetes mellitus, COPD, HIV/AIDS)

• Pathogen: The dimorphic fungus Sporotrix schenckii (Sporotrichon schenckii)
• Incubation period: days-months
• The dimorphic soil saprophyte Sporotrix schenckii lives on wood and plants. The pathogen can penetrate through injuries (e.g. during gardening) and goes into the deeper skin layers and lymph nodes/nodes. Aerogenic inoculation or ingestion usually lead to an extracutaneous manifestation (lungs, bones, etc.).
• Animals can be affected, transmission to humans, like human-to-human transmission, is not possible

• Erythematous-brownish, mostly asymptomatic linearly arranged, discreetly scaling, partly verrucous, occasionally ulcerating papules, plaques and nodules

• Clinical, especially the lymphogenic arrangement of the efflorescences is indicative
• Myco. smear
• Bact. smear (e.g. secondary impetigisation)
• Biopsy (both dermatopathological and microbiological work-up (e.g. of a MOTT)) recommended

• Mostly hands and feet are affected
• Rarely: Geischt and torso

• Recurrences are not rare
• No immunity
• Rare spontaneous healings

1. Galhardo MC, De Oliveira RM, Valle AC, et al. Molecular epidemiology and antifungal susceptibility patterns of Sporothrix schenckii isolates from a cat-transmitted epidemic of sporotrichosis in Rio de Janeiro, Brazil. Med Mycol 2008;46:141-51.
2. Marimon R, Serena C, Gene J, Cano J, Guarro J. In vitro antifungal susceptibilities of five species of sporothrix. Antimicrob Agents Chemother 2008;52:732-4.
3. Fernandez-Silva F, Capilla J, Mayayo E, Guarro J. Efficacy of posaconazole in murine experimental sporotrichosis. Antimicrob Agents Chemother 2012;56:2273-7.
4. Bunce PE, Yang L, Chun S, Zhang SX, Trinkaus MA, Matukas LM. Disseminated sporotrichosis in a patient with hairy cell leukemia treated with amphotericin B and posaconazole. Med Mycol 2012;50:197-201.
5. Kauffman CA, Pappas PG, McKinsey DS, et al. Treatment of lymphocutaneous and visceral sporotrichosis with fluconazole. Clin Infect Dis 1996;22:46-50.
6. Horsburgh CR, Jr., Cannady PB, Jr., Kirkpatrick CH. Treatment of fungal infections in the bones and joints with ketoconazole. J Infect Dis 1983;147:1064-9.
7. Calhoun DL, Waskin H, White MP, et al. Treatment of systemic sporotrichosis with ketoconazole. Rev Infect Dis 1991;13:47-51.
8. Kauffman CA. Old and new therapies for sporotrichosis. Clin Infect Dis 1995;21:981-5.
9. Hiruma M, Kawada A, Noguchi H, Ishibashi A, Conti Diaz IA. Hyperthermic treatment of sporotrichosis: experimental use of infrared and far infrared rays. Mycoses 1992;35:293-9.
10. Kauffman CA. Sporotrichosis. Clin Infect Dis 1999;29:231-6; quiz 7.
11. Pluss JL, Opal SM. Pulmonary sporotrichosis: review of treatment and outcome. Medicine (Baltimore) 1986;65:143-53.
12. Sharkey-Mathis PK, Kauffman CA, Graybill JR, et al. Treatment of sporotrichosis with itraconazole. NIAID Mycoses Study Group. Am J Med 1993;95:279-85.
13. Kauffmann, C. (2016). Retrieved 30 May 2016, from http://www.uptodate.com/contents/treatment-of-sporotrichosis?source=search_result&search=sporotrichose&selectedTitle=2~43
14. Lebwohl, Mark. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. Elsevier, 2014. Print.