To the Editor.—
Linear inflammatory skin nodules and pustules following environmental inoculation are classically caused by sporotrichosis. However, Nocardia is also a soil saprophyte and can cause disease that resembles cutaneous sporotrichosis. We report such a case.
Report of a Case.—
A 74-year-old man had a two-month history of non-Hodgkin's lymphoma and was undergoing therapy with chlorambucil (8 mg/d), his white blood cell counts remaining within normal limits. He presented with linear nodules and pustules on the dorsum of his right hand, extending onto his forearm. Six weeks previously, he had received a minor abrasion to the area while working in his rose garden. He was unsure as to the type of shrub that caused the injury. A single nodule appeared two weeks after this incident. The nodule became pustular after several days. Subsequent nodules and pustules formed proximally onto the forearm in a linear pattern resembling classic cutaneous sporotrichosis.
Wlodaver CG, Tolomeo T, Benear JB. Primary Cutaneous Nocardiosis Mimicking Sporotrichosis. Arch Dermatol. 1988;124(5):659-660. doi:10.1001/archderm.1988.01670050017009