Sporotrichosis — SCE Dermatology MCQ

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ModerateCutaneous InfectionSporotrichosisSCE Dermatology

A 60-year-old man has a deep fungal infection. He presents with a subcutaneous nodule on his hand that developed after a thorn prick while gardening. Over 3 weeks, new nodules appeared in a linear sporotrichoid pattern up his arm along the lymphatics. What is the most likely diagnosis?

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Correct answer: D — Sporotrichosis (Sporothrix schenckii)

The correct answer is D, Sporotrichosis (Sporothrix schenckii). Sporothrix schenckii is a dimorphic fungus found in soil, plant matter and thorny vegetation, and classically inoculated through minor trauma such as a thorn prick while gardening. Following inoculation, a primary nodule or ulcer forms at the site, and untreated infection spreads proximally along lymphatic channels, producing successive nodules in the characteristic sporotrichoid pattern. This history (gardening injury, hand nodule, ascending linear nodules over weeks) is the textbook presentation and is the single most common cause of this clinical pattern, termed nodular lymphangitis or sporotrichoid spread. Diagnosis is confirmed by culture or histology, and treatment is typically oral itraconazole for several months.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/skin-conditions