Sporotrichosis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alison Leibowitz [2]

Overview

Common physical examination findings of cutaneous sporotrichosis include painless pink to purple nodular lesions or erythematous plaque on the skin, which may begin to grow, ulcerate, and drain. These lesions characteristically manifest on upper extremities. Non-cutaneous forms of sporotrichosis are not generally associated with distinctive physical findings.

Physical examination

Appearance of the Patient

Vital Signs

  • Patients with cutaneous forms of sporotrichosis typically present normal with vital signs.

Skin

Cutaneous:

  • Initial nodular lesion at inoculation site
    • Small and painless
    • Pink to purple coloration
    • Plaque
    • Erythema
  • Nodular lesion grows when left untreated
    • Boil-like
    • Ulceration
    • Drainage
  • Older distal lesions will likely ulcerate and ooze, while proximal lesions manifest as nodules and undergo the same cycle. 

Disseminated Cutaneous:

  • Subcutaneous mass lesions
  • Diffuse purplish nodules
  • Disseminated, ulcerating lesions

HEENT

Lungs

  • Pulmonary sporotrichosis:
    • Productive coughing
    • Difficulty breathing due to pulmonary fibrosis
    • Swollen hilar lymph nodes

Extremities

  • Cutaneous sporotrichosis lesions are characteristic to upper extremities
    • Lesions on fingers
    • Lesions on arms
    • Lesions on hands

Neuromuscular

  • Patient is usually oriented to persons, place, and time.


Gallery

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Extremities
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References