Histopathology of cutaneous sporotrichosis in Rio de Janeiro: a series of 119 consecutive cases.
BACKGROUND
Sporotrichosis is the most common subcutaneous mycosis in Rio de Janeiro. Histopathological examination reveals diffuse granulomatous and suppurative dermatitis, and the fungus is rarely identifiable in tissue. We describe the histopathological features of cutaneous sporotrichosis, and investigate the association between them and the lack of visualization of the fungus.


METHODS
A total of 119 samples of confirmed sporotrichosis cases were studied. The characteristics of the inflammatory infiltrate, the presence of epidermal changes, necrosis and fibrosis, and the parasite burden were analyzed. The association between histopathological changes and the lack of visualization of the fungus was evaluated using prevalence ratios.


RESULTS
Granulomas were observed in all samples, suppurative granulomas in 100 (84%) and diffuse dermatitis in 114 (95.8%). Liquefaction and caseous necrosis were present in 78 (65.5%) and 52 (43.7%) samples, respectively. The fungus was not seen in 77 (64.7%) samples. Epithelioid, tuberculoid or foreign-body-type granulomas, caseous, fibrinoid or absent necrosis, predominance of lymphocytes among nonphagocytic cells and fibrosis were associated with the lack of visualization of the fungus.


CONCLUSIONS
The histopathological characteristics of sporotrichosis were variable when the causative fungus was not seen. In a proper context, the diagnosis of sporotrichosis remains a potential consideration even in the absence of demonstrable yeast.
Quintella
Leonardo Pereira
LP
Serviço de Anatomia Patológica, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. leonardo.quintella@ipec.fiocruz.br
Passos
Sonia Regina Lambert
SR
do Vale
Antônio Carlos Francesconi
AC
Galhardo
Maria Clara Gutierrez
MC
Barros
Monica Bastos De Lima
MB
Cuzzi
Tullia
T
Reis
Rosani Dos Santos
Rdos S
de Carvalho
Maria Helena Galdino Figueiredo
MH
Zappa
Mônica Barbato
MB
Schubach
Armando De Oliveira
Ade O
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D002648:Child; D005260:Female; D006099:Granuloma / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D012867:Skin / Q000382:microbiology / Q000473:pathology; D013174:Sporotrichosis / Q000382:microbiology* / Q000473:pathology*; D055815:Young Adult