Sporotrichosis classification: Difference between revisions

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===Cutaneous Forms===
===Cutaneous Forms===
Cutaneous forms of Sporotrichosis typically manifest following minor epidermal trauma. Patients may present with multiple forms simultaneously.
Cutaneous forms of Sporotrichosis typically manifest following minor epidermal trauma. Patients may present with multiple forms of cutaneous lesions.


Fixed form:
Fixed form:
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*Not associated with extracutaneous involvement.
*Not associated with extracutaneous involvement.
*Characterized by multiple epidermal lesions, which form at noncontiguous sites on the body.
*Characterized by multiple epidermal lesions, which form at noncontiguous sites on the body.


===Mucosal Form===
===Mucosal Form===

Revision as of 16:36, 7 January 2016

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

Overview

Sporotrichosis may be classified, according to the location of the lesions, into three subtypes: cutaneous, mucosal, and extracutaneous.

Classification

  • Presentations vary based upon numerous factors, such as the patient’s immunological status, the severity and depth of the inoculum, and the particular strain’s thermal zone of tolerance and pathogenicity.

Cutaneous Forms

Cutaneous forms of Sporotrichosis typically manifest following minor epidermal trauma. Patients may present with multiple forms of cutaneous lesions.

Fixed form:

  • Staying localized within the subcutaneous tissue, the fungus transforms into its yeast form.
  • Manifests at the site of inoculation with at least one, frequently ulcerated, lesion. The lesions are characterized by red edges due to capillary dilation and congestion.
  • Fixed form sporotrichosis may spontaneously regress [1]
  • Fixed form sporotrichosis is the main clinical presentation in child patients.
  • Initially manifest as painless nodules, which then become palpable, purulent, and ulcerated

Lymphocutaneous form:

  • The yeast form of S. schenckii extends through the nearby lymphatic vessels.[2]
  • Approximately 70% of the cases of sporotrichosis may be classified as lymphocutaneous sporotrichosis.[3]
  • The primary lesion frequently manifests on the upper extremities and is initially painless.
  • Initially a patient will present with a papule or pustule, which later expands into a subcutaneous nodule.[3]
  • Subepidermal pressure results in ischemia, and the lesion evolves into a palpable, purulent and ulcerated nodule.
  • Secondary lesions manifest along the adjacent lymphatic pathway.[4]
  • The presence of systematic symptoms is rare.

Disseminated cutaneous form:

  • The hematogenous dissemination of the yeast form of S. schenckii.
  • Not associated with extracutaneous involvement.
  • Characterized by multiple epidermal lesions, which form at noncontiguous sites on the body.

Mucosal Form

Extracutaneous Form

References

  1. Saha A, De A, Datta P, Das N. Fixed cutaneous sporotrichosis: a diagnostic challenge overcome by incidental discovery of asteroid bodies S. Journal of Pakistan Association of Dermatologists. 2010;(20):120-122.>
  2. Stalkup J. R., Bell K., Rosen T.. 2002. Disseminated cutaneous sporotrichosis treated with itraconazole. Cutis 69:371–374.>
  3. 3.0 3.1 Goncalves AP. Sporotrichosis. In: Canizares O, Harman R, editors. Clinical Tropical Dermatology, 2nd edn. Philadelphia: Blackwell Scientific Publications; 1992. p. 88-93.>
  4. Mahajan VK (2014). "Sporotrichosis: an overview and therapeutic options". Dermatol Res Pract. 2014: 272376. doi:10.1155/2014/272376. PMC 4295339. PMID 25614735.