bubble_chart Overview

Sporotrichosis is a chronic inflammation of the skin, subcutaneous tissue, and adjacent lymphatic system caused by Sporothrix schenckii. It often occurs after minor skin trauma when coming into contact with materials contaminated by the pathogen, hence lesions typically appear on exposed areas. Clinically, it is classified into three types based on lesion characteristics: fixed, lymphocutaneous, and disseminated.

bubble_chart Clinical Manifestations

1. It is more common in farmers or outdoor workers, often with a history of trauma before the onset of the disease; 2. Fixed type: Lesions occur at the original site, presenting as nodules, ulcers, or infiltrating erythema, with no pain; 3. Lymphangitic type: Lesions appear as painless purple-red or black nodules or ulcers along the lymphatic vessels, arranged in a linear pattern; 4. Disseminated type: Rare, involving the skin and mucous membranes, with scattered subcutaneous nodules or ulcers throughout the body and obvious systemic symptoms.

bubble_chart Diagnosis

1. The patients are mainly farmers, often with a history of trauma before the onset of the disease; 2. The skin lesions predominantly occur on exposed areas; 3. Characteristics of skin lesions vary by clinical type; 4. Direct microscopic examination and fungal culture of the skin lesions are positive for Sporothrix schenckii; 5. Histopathological examination of the skin lesions (PAS staining) reveals asteroid bodies.

bubble_chart Treatment Measures

Treatment Principles 1. Oral systemic antifungal drugs (preferred: 10% potassium iodide solution); 2. Topical antifungal preparations; 3. Local surgical excision, laser, cryotherapy, thermotherapy, or physical therapy.

Medication Principles 1. For localized and small skin lesions, surgical excision, laser, or cryotherapy may be chosen; 2. For widespread or larger skin lesions, oral systemic antifungal drugs should be used; 3. Potassium iodide is contraindicated in patients with iodine allergy or pulmonary/subcutaneous nodules; 4. 5-Fc is often combined with other antifungal drugs to reduce toxicity and side effects and minimize resistance; 5. Amphotericin B has significant side effects and is only used when other antifungal treatments fail; 6. Systemic treatment may be supplemented with topical antifungal preparations, thermotherapy, or physical therapy.

bubble_chart Cure Criteria

1. Cure: Skin lesions disappear, and fungal direct microscopy and culture are negative once a month for three consecutive times; 2. Improvement: Skin lesions partially disappear, and fungal tests are negative or positive; 3. No cure: Skin lesions show no improvement, and fungal tests are positive.