Ans. A. Sporotrichosis
Sporotrichosis is caused by infection with Sporothrix schenkii, a dimorphic fungus, found in soil, wood, and plant surfaces.
Lymphocutaneous sporotrichosis, the most common form, presents as a small, nontender, erythematous papulonodule at the site of the primary injury.
This lesion may be smooth or verrucous, often ulcerates, and develops raised red borders.
Over days to weeks, proximal subcutaneous nodules form along the lymphatic drainage, and may ulcerate. Fungal cultures and tissue biopsies aid in the diagnosis.
Physical examination showed an ulcerated, raised, dry, crusted lesion on the lateral surface of the left thumb, with four proximal raised, erythematous, subcutaneous nodules, without epitrochlear or axillary lymphadenopathy.
Purulent material was aspirated from one of the nodules; gram, fungal and mycobacterial stains showed no organisms.