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Abstract
Sporotrichosis is a fungal infection known for its distinct pattern of infectious skin nodules. Several conditions can present with lesions that appear in a sporotrichoid pattern. An 82-year-old man that presented with three cutaneous nodules on his right leg in a sporotrichoid manner is described; biopsy of each lesion revealed a keratoacanthoma. In addition to keratoacanthomas, other neoplasms—albeit rarely—may be observed to occur in a sporotrichoid manner. These included squamous cell carcinoma (three patients), lymphoma (two patients), and one patient with each of the following: epithelioid sarcoma, Langerhans cell histiocytosis, melanoma, and peripheral nerve sheath tumor. The 10 patients whose cancer had cutaneous lesions that presented in a sporotrichoid distribution ranged from 28 to 83 years old. The tumors equally appeared on either the upper extremity (five patients) or the lower extremity (five patients). Treatments included systemic chemotherapy, surgical intervention, and radiation. Three of the patients died secondary to their tumors. In conclusion, various infections and some miscellaneous disorders can present in a sporotrichoid pattern. Keratoacanthomas can be added to the list of cancers (which include squamous cell carcinoma, lymphoma, epithelioid sarcoma, Langerhans cell histiocytosis, melanoma, and peripheral nerve sheath tumor) whose skin lesions have appeared in a sporotrichoid distribution. When cutaneous lesions appear in a sporotrichoid manner, biopsy of the tissue—for not only microscopic examination but also bacterial, fungal, and mycobacterial cultures—should be considered.
Highlights
Keratoacanthomas are malignant skin neoplasms that may appear suddenly and grow rapidly [1,2]
Keratoacanthomas can be added to the list of cancers whose skin lesions have appeared in a sporotrichoid distribution
Infections, neoplasms, and miscellaneous conditions may appear in a sporotrichoid distribution
Summary
Keratoacanthomas are malignant skin neoplasms that may appear suddenly and grow rapidly [1,2]. A man with eruptive keratoacanthomas in a sporotrichoid distribution is described, and the features of patients whose neoplasms have had a sporotrichoid pattern are reviewed. An 82-year-old man presented with the new onset of rapidly enlarging skin lesions on his right leg. He has a history of actinic keratosis (periodically treated with cryotherapy using liquid nitrogen) and four nonmelanoma skin cancers (three basal cell carcinomas and one squamous cell carcinoma that were excised without recurrence). The individual keratoacanthomas had a sudden onset and rapid growth They appeared on the right leg of an 82-year-old man and in a sporotrichoid distribution. Correlation of the clinical presentation, pathology findings, and laboratory results established a diagnosis of eruptive keratoacanthomas in a sporotrichoid distribution. There is no evidence of recurrence at his follow-up examination six months later
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