title: Disseminated cutaneous sporotrichosis treated with itraconazole.
abstract: A 72-year-old Hispanic man with diabetes presented with a 4-week history of a tender non-healing ulcer on the fifth digit of the left hand and a 3-day history of fever, chills, malaise, anorexia, and tender fluctuant nodules on the abdomen and left elbow. The patient, an avid gardener, was using prednisone and methotrexate for a debilitating seronegative polyarthropathy. A diagnosis of disseminated cutaneous sporotrichosis was made based on epidemiologic risk factors, clinical appearance, histopathologic examination, and a positive fungal culture. Use of prednisone was discontinued, the dosage of methotrexate was decreased, and use of oral itraconazole 400 mg/day was instituted. The patient's lesions cleared within 5 months, and no recurrence was noted during a 3-month follow-up. This case illustrates the typical association of the rare entity of disseminated cutaneous sporotrichosis with immunosuppression, an unusual lack of internal involvement, and a gratifying response to itraconazole.
authors.affiliation: Department of Dermatology, Baylor College of Medicine, Houston Veterans Affairs Medical Center, Texas, USA.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Stalkup
authors.forename: Katherine
authors.initials: K
authors.lastname: Bell
authors.forename: Ted
authors.initials: T
authors.lastname: Rosen
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D048909:Diabetes Complications; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use*; D008297:Male; D013174:Sporotrichosis / Q000188:drug therapy*
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole