Therapy of sporotrichosis

Sporotrichosis is a fungal infection caused by the dimorphic organism, Sporothrix schenkii. This etiologic agent typically gains entrance into the skin by traumatic implantation of infected soil or plant materials. The majority of cases are of the fixed cutaneous or lymphangitic cutaneous varieties, and less commonly, hematogenous dissemination to skin or viscera occurs. Untreated, the disease may spontaneously resolve or persist and gradually progress over time, its virulence being less than that of other dimorphic fungi. Potassium iodide remains a favored treatment for uncomplicated cutaneous disease. Amphotericin B, with its high toxicity, has historically been reserved for recalcitrant cutaneous or disseminated disease. Itraconazole, the newest triazole antifungal to become available in the United States, seems to be highly effective against Sporothrix schenkii without significant adverse effects and will likely become the first line therapy for all forms of this disease in the future.