Atypical cutaneous sporotrichosis. The response to itraconazole and surgery

Sporotrichosis is a subcutaneous (rarely extracutaneous) fungal disease caused by Sporothrix schenckii. Cutaneous sporotrichosis has two well-defined forms: lymphocutaneous and stable. In lymphocutaneous sporotrichosis, lesions arise along lymphatic vessels, generally in limbs. The stable form is rarer and consists of a single, generally facial, lesion. We report the case of a 70-year-old male farmer with a single lesion on the right nostril that had been removed repeatedly. After 5 years, new, linearly distributed lesions appeared. Fungal cultures of biopsy tissues revealed S. schenckii. The evolution and response to treatment with itraconazole, potassium iodide, terbinafine, and surgery is discussed.