Bilateral Thumb Lymphocutaneous Sporotrichosis

Sporotrichosis is a fungal infection caused by Sporothrix, a thermally dimorphic fungus that affects humans and animals. It is most commonly associated with cutaneous and subcutaneous tissue exposed to fungus-containing soil, moss, or organic material. Sporotrichosis is challenging to diagnose because it can mimic various other dermatological diseases. Thus, as demonstrated in this case, the importance of making a diagnosis based on history and a thorough physical examination, as misdiagnosis can delay proper treatment. A 53-year-old Malay woman presented with bilateral thumb swelling that had been treated with two courses of antibiotics but had failed, resulting in disease progression. Clinical suspicion of lymphocutaneous sporotrichosis was made based on history, physical examination, and investigations finding. The patient was started on an empirical course of Itraconazole 200mg twice daily, and the lesions responded well.