Fixed cutaneous disease also is known as nonlymphatic sporotrichosis. This appears as a scaly, acneform, verrucous or ulcerative nodule that remains localized. Satellite lesions and lymphadenopathy do not occur in this form of sporotrichosis. Fixed cutaneous lesions may rarely resemble pyoderma, rosacea, pyoderma gangrenosum, and keratoacanthomas. Disseminated disease can result in pyelonephritis, orchitis, mastitis, arthritis, synovitis, meningitis, osseous infection, or, rarely, pulmonary disease.
Cutaneous lesions can occur in the setting of disseminated infection.
Clinical signs and symptoms may be blunted in the presence of elevated glucocorticoid states or systemic steroid therapy. Sporotrichosis in this setting has resembled erysipeloid cellulitis. Sporotrichosis is caused by S schenckii, a dimorphic fungus. Inform the laboratory that sporotrichosis is clinically suspected. The laboratory should be alerted to the possibility of an atypical mycobacterial infection, particularly if Mycobacterium marinum is suspected, to ensure that appropriate cultures are performed.