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Sporotrichosis. Presented by Dr. Harry J. Hurley; Capt Samuel L. Moschella, MC, USN; Cdr D. L. Baxter, MC, USN; and Lt S. E. Permowicz, MC, USN.
In October 1966, this 78-year-old white man injured the dorsum of his left hand on a ladder while working in his garden among shrubs and rose bushes. The abrasion soon ulcerated and failed to heal. He was followed up by a private physician and dermatologist for two months prior to admission with only little improvement (Burow's soaks and steroid spray).
The patient appears normal for his age. He presents a plaque about 4 × 5 cm in size which contains a purulent ulcer with a base of normal appearing granulation tissue, located centrally over the dorsum of the left hand. There are four or five purpuric macules over the medial aspect of the left arm. The lungs are emphysematous, but clear. His abdomen has no organomegaly. There is no palpable lymphadenopathy. The patient has osteoarthritis of both knees.
Corson JK, Graham JH, Siegel JM. PHILADELPHIA DERMATOLOGICAL SOCIETY. Arch Dermatol. 1968;97(1):81-87. doi:10.1001/archderm.1968.01610070087014