Table 2.

Case reports of sporotrichosis infections misdiagnosed as pyoderma gangrenosum.

Author, year	Age and sex	History	Risk factors	Site of lesion	What led to initial diagnosis of PG?	Initial management	Sporotrichosis diagnosis (Method)	Treatment
Byrd et al., 20012	59 and F	6 months Hx of ulcerated nodule	Ankle prick by rose thorn	Right leg	Unknown, but was diagnosed as PG after ulceration of lesion	Prednisone, oral antibiotics, azathioprine, and cyclosporine	Cutaneous sporotrichosis (Tissue culture, positive PAS stain)	Itraconazole (200 mg/TID) for 18 months
Yang et al., 20063	40 and M	1 year Hx of non-healing ulcer with history of sarcoidosis	Blackberry picking	Left forearm	Two previously nondiagnostic biopsies, negative tissue culture, and history of pulmonary sarcoidosis led to suspicion of ulcerative cutaneous sarcoidosis and pyoderma gangrenosum	Prednisone	Disseminated cutaneous sporotrichosis (Biopsy and culture)	Itraconazole (200 mg/d) for 2 months
Lima et al., 20174	39 and F	Incomplete response to itraconazole from 2 years ago	Scratched by sporotrichosis-infected cat	Abdomen progressing to right arm	Incomplete response to itraconazole from 2 years ago led to revision of diagnosis to PG	Corticosteroids, immunosuppressive drugs, infliximab, non-opioid analgesics, and morphine	Disseminated cutaneous sporotrichosis (Biopsy, tissue culture)	Liposomal amphotericin B (400 mg/day) for 6 weeks followed by itraconazole (400 mg/d) for 12 months
Charles et al., 20175	57 and F	10 months Hx of three enlarging ulcers after arthropod bite	Trauma	Right arm	Biopsy showed granulomatous reaction, incomplete response to itraconazole, ulcerative characteristic, and severely painful pattern led to presumed diagnosis of PG with secondary infection	Levofloxacin, ceftriaxone, prednisone, penicillin, and topical clobetasol	Cutaneous sporotrichosis (Tissue culture, positive PAS stain)	Itraconazole (200 mg/d) for 3 months followed by 200 mg/BID
Takazawa et al., 20186	47 and M	4 months Hx of skin ulcer on leg after fall	Trauma	Right lower leg	Medical history of ulcerative colitis and clinical presentation of skin ulcer	Topical steroid	Fixed cutaneous sporotrichosis (Tissue culture, PAS stain, PCR)	Potassium iodide (500 mg) for 2 weeks followed by 1000 mg for 3 weeks
Saeed et al., 20197	35 and F	Fell on right forearm	Cat owner, previously worked as a landscaper	Legs, arm, and abdomen	Negative stains and numerous ulcers	Prednisone doxycycline	Osteoarticular and disseminated sporotrichosis (Tissue culture)	Liposomal amphotericin B for 28 days, itraconazole (200 mg/TID followed by 200 mg/BID). Amphotericin (4 mg/kg/d) for 3 weeks followed by posaconazole (300 mg/d) for 12 months
White et al., 20198	62 and M	1 month Hx of thigh lesion after playing golf		Left thigh	Atypical presentation ulcer without lymphocutaneous spread	Cephalexin for group B streptococcus prednisone, cyclosporine, ustekinumab, and IVIG	Disseminated sporotrichosis (Tissue and blood culture)	Liposomal amphotericin B (5 mg/kg IV daily), posaconazole (300 mg/BID followed by 300 mg/d). Itraconazole (200 mg/q8 h × 9 followed by 200 mg/q12 h) for 10 months after discharge; terbinafine (250 mg/d) later added due to wound progression
Present case	78 and M	No relevant history	None	Left arm	Negative PAS stain, and lack of tissue culture	Cyclosporine, mycophenolate, IVIG, prednisone, and ustekinumab	Fixed cutaneous sporotrichosis (Tissue culture)	Itraconazole (200 mg/d) for 4 months

PG: pyoderma gangrenosum; PAS: periodic acid–Schiff; IVIG: IV immunoglobulin; BID: two times a day; TID: three times a day.