Sporotrichosis of the Nose with Spontaneous Cure | Spontaneous Remission Database

Abstract

Sporotrichosis is caused by Sporothrix schenckii. The organism has worldwide distribution and can be found on both living and dead organic material, especially soil, moss, hay, and wood. The usual clinical picture is one of a suppurative abscess, often with lymphangiectatic spread. Iodides constitute the mainstay of treatment, but in certain situations amphotericin B, surgery, or thermotherapy is indicated. Spontaneous resolution has only been documented once but has been alluded to but not documented in another report. I wish to report the spontaneous resolution of cutaneous sporotrichosis in a young girl.

Case Details

Personal Characteristics

A 39-year-old painter

Clinical Characteristics

An asymptomatic lesion on the right side of the nose for 1 month. Grouped scaly papules were noted over the right side of the nose. There were no abnormalities of the surrounding skin or of the regional lymphatics and lymph nodes. A specimen 2 mm in diameter obtained by punch biopsy showed marked hyperkeratosis, irregular acanthosis and a dense infiltrate of plasma cells, lymphocytes and multi-nucleated, foreign body type giant cells in the upper dermis. Periodic acid-schiff and ziehl-neelsen stains revealed no organisms, but s. Schenckii was cultured and its identity confirmed by morphologic studies. A chest roentgenogram was normal.

Remission Characteristics

After 1 month the patient returned. No treatment had been given, pending a laboratory diagnosis, but his lesion was smaller. He returned again after 3 weeks and the lesion had nearly disappeared. Eleven weeks after the initial visit all that remained was a slightly depressed scar, which was not the result of a biopsy.

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Additional Notes

The patient stated that the lesion had begun as a pimple, and after he squeezed it, it started enlarging. He did not recall any prior trauma to the area.