Subcutaneous Mycoses

Overview
  • A variety of dimorphic fungal species cause Subcutaneous Mycoses which are fungal infections that extend into the dermis and may spread within superficial lymphatics. These species are generally widely spread in soil and plants and gain access to the dermis via breaks or trauma to the skin.
Sporotrichosis
  • Overview
    • Sporotrichosis is caused by the organism "Sporothrix schenckii" which is widely present on plants. It is generally an occupational hazard of gardeners, florists, and others who frequently work with plants.
  • Clinical Consequences
    • Initially a nodule develops at the site of traumatic inoculation, undergoes necrosis, and may ulcerate. In many patients, local lymphatic spread of the organism manifests as the iterative development of nodules progressively along superficial lymphatic tracts that drain the initial lesion. These nodules in turn may undergo necrosis and ulcerate over time.
  • Treatment
    • Oral azoles such as itraconazole
Chromoblastomycosis
  • Overview
    • Chromoblastomycoses are caused by two soil-dwelling fungi "Phialophora" and "Cladosporium". Chromoblastomycoses mostly affect rural workers following traumatic inoculation.
  • Clinical Consequences
    • Lesions initially appear as painless verrucous and wart-like outgrowths of the skin. Overtime, these lesions can slowly grow to large sizes, coalesce and form cauliflower-like outcroppings of tissue.
  • Treatment
    • Lesions are locally excised together with oral administration of azoles such as itraconazole.