PMC9899364_01
Clinical features of disseminated sporotrichosis with oral manifestation (case 1). (A,B) Multiple cutaneous, erosive, and erythematous papules with crust formation on perioral region, arms and thigh. (C,D) Multiple ulcers of varying size in the palate and dorsal surface of the anterior tongue.
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F1
Intra-oral examination revealed multiple ulcers and erythematous plaques in the hard and soft palates, as well as on the dorsum and lateral surfaces of the tongue (Fig. 1).
PMC9899364_02
Clinical features of disseminated sporotrichosis with oral manifestation in a HIV patient (case 2). A and B. Multiple crateriform ulcers affecting the skin of the centrofacial region. C and D. Diffuse ulcerated mucosa lesions with granular surface in the hard palate and gingivae, associated with pseudomembranous candidiasis co-infection in tongue, buccal mucosa and palate.
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F2
Intra-oral examination showed diffuse superficial granular ulcers of moriform surface and variable size, located in the hard/soft palate, gingivae, buccal mucosa and tongue (Fig. 2).
Microscopic features of oral sporotrichosis. A. Fragment of oral mucosa presenting granulomatous chronic inflammation with multinucleated giant cells, and pseudoepitheliomatous hyperplasia of the overlying epithelium. Fungi structures were highlighted by (B) Periodic acid Schiff and (C) Gomori-Grocott metenamine silver stain, and also observed in the smears collected by (D) exfoliative cytology (Papanicolaou). E and F. Yeast culture of sporotrichosis. Membranous colonies of white-creamy and black-leathery color (E). Microscopic evaluation of the colonies showing septate hyphae with "daisy-like" arrangement at the end of the conidiophores (F).
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F3
Periodic acid Schiff and Grocott-Gomori methenamine-silver stains highlighted round yeast-like fungal structures, which showed spherical, oval, or elongated (cigar-shaped) morphology by exfoliative cytology evaluation (Fig. 3). Microscopic evaluation of the colonies showed septate hyphae of pyriform conidia with typical "daisy-like" arrangement at the end of the conidiophores (Fig. 3).