Medical Care

Medical therapy is the standard of care for sporotrichosis. Patients are commonly treated with an oral antifungal agent on an outpatient basis. Surgical therapy, other than to perform a biopsy from a lesion for establishing the diagnosis, is rarely used as a form of treatment. Aggressive treatments are seldom necessary. This fungus does not grow well in temperatures higher than 38.5°C, so warm compresses are often used as adjunctive therapy. See the Medication section for a suggested pharmaceutical approach to treating sporotrichosis.

Consultations

Consult with a dermatologist.

Activity

Activity limitations, determined on a case-by-case basis, may be necessary for optimal care. Wearing long sleeves and gloves is recommended when gardening or handling plant matter that may cause sporotrichosis.

Medication

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Zhou CH, Asuncion A, Love GL. Laryngeal and respiratory tract sporotrichosis and steroid inhaler use. Arch Pathol Lab Med. 2003 Jul. 127(7):893-4. [QxMD MEDLINE Link].
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Almeida-Paes R, Pimenta MA, Pizzini CV, Monteiro PC, Peralta JM, Nosanchuk JD. Use of mycelial-phase Sporothrix schenckii exoantigens in an enzyme-linked immunosorbent assay for diagnosis of sporotrichosis by antibody detection. Clin Vaccine Immunol. 2007 Mar. 14(3):244-9. [QxMD MEDLINE Link].
Bonifaz A, Tirado-Sánchez A. Cutaneous Disseminated and Extracutaneous Sporotrichosis: Current Status of a Complex Disease. J Fungi (Basel). 2017 Feb 10. 3 (1):[QxMD MEDLINE Link]. [Full Text].
Benvegnú AM, Stramari J, Dallazem LND, Chemello RML, Beber AAC. Disseminated cutaneous sporotrichosis in patient with alcoholism. Rev Soc Bras Med Trop. 2017 Nov-Dec. 50 (6):871-873. [QxMD MEDLINE Link].
Sharma NL, Mahajan VK, Verma N, Thakur S. Cutaneous sporotrichosis: an unusual clinico-pathologic and therapeutic presentation. Mycoses. 2003 Dec. 46(11-12):515-8. [QxMD MEDLINE Link].
Bonifaz A, Fierro L, Saul A, Ponce RM. Cutaneous sporotrichosis. Intermittent treatment (pulses) with itraconazole. Eur J Dermatol. 2008 Jan-Feb. 18(1):61-4. [QxMD MEDLINE Link].
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Baroni A, Palla M, Iovene MR, et al. Sporotrichosis: success of itraconazole treatment. Skinmed. 2007 Jan-Feb. 6(1):41-4. [QxMD MEDLINE Link].
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Media Gallery

Sporotrichosis with cutaneous necrosis and lymphangitic (sporotrichoid) spread. A 28-year-old white man presented for evaluation of a poorly healing, asymptomatic, round plaque acquired on the dorsum of his left hand. The lesion had been present for approximately 3 weeks.
Glucose-peptone agar culture plates revealing colony growth of Sporothrix schenckii. The left plate reveals older colonies as dark brown or black, and the right plate reveals younger white colonies with a brown center, characteristic of this fungus.
Microscopic examination of a blue dye preparation from the colony surface reveals elongated septate hyphae with groups of microconidia in a flowerlike arrangement.
A well-circumscribed, moderately elevated, erythematous plaque with central ulceration is found on the dorsum of this patient's left hand. Potassium chloride (KOH) stain was negative for fungal elements.
A 2 X 2 cm, dome-shaped, well-circumscribed, erythematous plaque is shown proximal to the left ring finger. The lesion was draining a serosanguineous fluid. No purulence was noted.
Biopsy rarely reveals the 6-mcg cigar-shaped yeast within tissue macrophages as shown in this histologic section. This is the morphology that Sporothrix schenckii assumes at 37°C.
Moist cream-colored colonies with a central, dark, leathery, and wrinkled surface growing at 25°C is highly suggestive of Sporothrix schenckii.
A fresh agar slant of Sporothrix schenckii reveals moist, white-to-cream–colored, yeastlike colonies.
Cutaneous, ulcerating, painless nodule on the hand and a classic sporotrichoid lymphangitic pattern spreading proximally up the arm.

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Author

William P Baugh, MD Assistant Clinical Professor of Dermatology, Western University of Health Sciences; Medical Director, Full Spectrum Dermatology; Consulting Staff, Department of Dermatology, St Jude Medical Center

William P Baugh, MD is a member of the following medical societies: American Academy of Dermatology, American Society for Laser Medicine and Surgery, Christian Medical and Dental Associations

Disclosure: Nothing to disclose.

Coauthor(s)

Cynthia C Lazzaro, DO Physician

Cynthia C Lazzaro, DO is a member of the following medical societies: American Academy of Dermatology, American Osteopathic College of Dermatology

Disclosure: Nothing to disclose.

Brad S Graham, MD Consulting Staff, Dermatology Associates of Tyler

Brad S Graham, MD is a member of the following medical societies: Alpha Omega Alpha, Texas Dermatological Society, American Academy of Dermatology, American Society of Dermatopathology

Disclosure: Nothing to disclose.

Natalie Ana Baugh California State University, Long Beach

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Larry I Lutwick, MD, FACP Editor-in-Chief, ID Cases; Moderator, Program for Monitoring Emerging Diseases; Adjunct Professor of Medicine, State University of New York Downstate College of Medicine

Larry I Lutwick, MD, FACP is a member of the following medical societies: American Association for the Advancement of Science, American Association for the Study of Liver Diseases, American College of Physicians, American Federation for Clinical Research, American Society for Microbiology, Infectious Diseases Society of America, Infectious Diseases Society of New York, International Society for Infectious Diseases, New York Academy of Sciences, Veterans Affairs Society of Practitioners in Infectious Diseases

Disclosure: Nothing to disclose.

Chief Editor

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association

Disclosure: Nothing to disclose.

Additional Contributors

Gary J Noel, MD Professor, Department of Pediatrics, Weill Cornell Medical College; Attending Pediatrician, New York-Presbyterian Hospital

Gary J Noel, MD is a member of the following medical societies: Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.