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August 1996

Disseminated Ulcerated Papules and Nodules

Author Affiliations

Wright State University School of Medicine, Dayton, Ohio

Arch Dermatol. 1996;132(8):965-966. doi:10.1001/archderm.1996.03890320113018

REPORT OF A CASE  A 33-year-old black man with a 5-year history of human immunodeficiency virus infection presented with a 3-month history of slowly enlarging, nonpainful, papular to ulcerated nodules that had begun on his face and had spread over his entire body.The cutaneous examination revealed multiple firm, violaceous, necrotic nodules and papules involving the face, neck, torso, and extremities (Figure 1 and Figure 2). There also was marked lymphadenopathy involving the anterior and posterior cervical nodes, the axillary nodes, and the epitrochlear and inguinal nodes.A punch biopsy specimen of a nonnecrotic papule is shown in Figure 3 and Figure 4 (periodic acid-Schiff stain).What is your diagnosis?

DIAGNOSIS:  Cutaneous disseminated sporotrichosis.

DISCUSSION  Sporotrichosis is caused by Sporothrix schenckii and occurs in 4 forms: lymphocutaneous, fixed cutaneous, cutaneous disseminated, and systemic. The most common clinical presentation is that of the lymphocutaneous or fixed cutaneous form. The cutaneous disseminated

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