Sporotrichosis

• Schenck 1898
• Lutz u. Splendore 1907

Rose gardener's disease

Fungal infection of the cutis and subcutis by Sporotrix schenckii.

• Categorisation
  • Fixed cutaneous shape
  • Lymphocutaneous form
  • Disseminated cutaneous form
  • Extracutaneous disseminated form.

  • Note: in the disseminated and extracutaneous form, bones, joints, lungs, meninges or other visceral organs are usually affected. 

• Occurs worldwide, but is a rare disease in Europe.
• Especially in the tropics and subtropics.
• Mexico: most common, deep fungal infection.

• The infection is mainly observed in the rural population.

• More 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 reaches the deeper layers of the skin and lymph nodes. Aerogenic inoculation or ingestion usually lead to an extracutaneous manifestation (lung, bone, etc.).

• Animals may be affected. A transmission from animal to human as well as a human to human transmission is not possible.

• Erythematous-brownish, usually asymptomatic, linearly arranged, discreetly scaly, sometimes verrucous, occasionally ulcerating papules, plaques and nodules.
    

• Clinic, especially the lymphogenic arrangement of efflorescences is indicative
• Myco. smear

• Bakt. smear (e.g. of a secondary impetigation)

• Biopsy (both dermatopathological and microbiological processing (e.g. MOTT)) recommended. 

• Hands and feet are particularly affected.
• Rarely: Face and trunk.

• Recurrences are not uncommon.

• No immunity.

• Rarely spontaneous healings.

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14. Lebwohl, Mark. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. Elsevier, 2014. Print.