Epidemiological, Clinical, and Histopathological Characteristics of Patients with Sporotrichoid Lymphocutaneous Infection in Southern Thailand: A 10-Year Retrospective Study

Sporotrichoid lymphocutaneous infection is caused by a variety of pathogens. However, in most cases, the causative pathogen cannot be identified on the basis of clinical and histopathological features. We examined the clin-ical manifestations, histopathologic findings, causative pathogens, treatment, and prognostic factors of sporotrichoid lymphocutaneous infection, specifically in the context of Thailand. The electronic medical records of patients with sporo-trichoid lymphocutaneous infection who visited Songklanagarind Hospital from January 2000 to December 2010 were reviewed. A total of 53 patients were included; 41 (77.4%) were female, 12 (22.6%) were male, and the mean (SD) age was 52.9 (6 15.9) years. Nodules, plaques, and papules were the most commonly observed morphologies. Upper extremities were the most commonly infected sites. Mammal-caused injuries were associated with fungal infection but not at a statistically significant level. The most common histopathologic finding was suppurative granuloma. The identi-fied causative pathogens were mainly dematiaceous fungus and occasionally nontuberculous Mycobacterium. Itracon-azole was the medication of choice for empiric and specific treatment of the patients with confirmed fungal infection. Dematiaceous fungi were the most common identified pathogens causing sporotrichoid lymphocutaneous infection in southern Thailand. Empirical itraconazole is useful, especially in patients who report contact injury caused by pets at the primary lesion site. Skin biopsy for tissue histopathology and culture is essential.

Automated summary

This study examined the clinical features, histopathology, treatment, and prognosis of sporotrichoid lymphocutaneous infection in Thailand. The most common identified pathogens causing this infection were dematiaceous fungi. Empirical itraconazole treatment was found to be effective, particularly in patients with contact injuries caused by pets.