PMC9650217_01
Multiple cutaneous lesions caused by Sporothrix globosa. A 47-year-old man with multiple verrucous and ulcerated nodules with overlying necrotic eschar on left upper limb, scattered crusted papules and plaques on right thigh.
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F1
Further examination of the trunk and extremities revealed scattered crusted papules and plaques on the right thigh (Figure 1).
(A) Culture of Sporothrix globosa (Sabouraud dextrose agar, 28 C) grew grayish white colonies. (B,C) Slide culture and scanning electron microscope observations revealed thin hyphae and denticle microconidia like "daisy flowers".
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F2
The fungal culture on sabouraud dextrose agar (SDA) at 28 C for 10 days grew into grayish-white colonies (Figure 2A). Microscopic examination with slide culture and scanning electron microscope observations of the colony indicated the morphology of Sporothrix spp. (Figures 2B,C).
After self-discontinuation of voriconazole, the existing lesions (verrucous and ulcerated nodules on the left upper limb, and papules and plaques on the right thigh) recurred and worsened, extending to the right leg with crusted plaque.
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F3
After 8 months of antifungal treatment, the patient self-discontinued voriconazole due to financial constraints, and the lesions recurred and worsened (Figure 3).
After 6-month therapy of potassium iodide, the patient achieved complete remission with only scarring remaining.
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F4
He continued potassium iodide treatment for another 5 months until there was a complete resolution of lesions (Figure 4).