A rare case of oral sporotrichosis: painful nodule in the buccal mucosa

Hélder Domiciano Dantas Martins, Eduarda Gomes Onofre de Araújo, Livian Isabel de Medeiros Carvalho, Breno Estevam Silva de Souza, Gustavo Henrique Perazzo de Morais, Felipe Queiroga Sarmento Guerra, Danyel Elias da Cruz Perez, Paulo Rogério Ferreti Bonan

Abstract

Sporotrichosis is a common fungal infection that presents with various clinical manifestations, including cutaneous, mucosal, osteoarticular, systemic and immunoreactives. Its occurrence in the oral cavity is uncommon, more frequently observed in immunocompromised patients, and manifests as ulcerative lesions. In the present case, a 62-year-old patient presented with complaints of pain in the buccal mucosa. Upon extraoral examination, nodules with an ulcerated and crusted area were noted on the left wrist and forearm, along with an ulcer located on the medial side of the right heel. Intraoral examination revealed a painful nodule with normal coloration on the left buccal mucosa. Initially, an incisional biopsy was performed, revealing a diffuse inflammatory infiltrate with areas of necrosis. Subsequently, Periodic Acid Shiff (PAS) staining and cell culture were performed, revealing structures consistent with Sporothrix spp. Based on these findings, the diagnosis of sporotrichosis was established, and itraconazole 100 mg (1 tablet every 12 hours) for 6 months was chosen as the therapeutic approach. The patient exhibited complete resolution of the lesions.