We conducted a transversal retrospective study with secondary data collection from 25
cases of sporotrichosis, treated at a teaching unit in inner São Paulo (Brazil),
between the years 2003-2013. We found that the prevalence was higher in men (72%),
rural workers (44%) and those living in rural areas (60%), with an average age of
42.48 years. The median between the onset of lesions and diagnosis was six weeks.
Lesions predominated in the upper limbs (92%), and were classified as lymphocutaneous
(80%) and fixed cutaneous (20%) forms. Clinical cure was observed in 62.5% of the
cases treated with potassium iodide and 100% of cases treated with itraconazole.
We report a case of granulomatous slack skin, a rare and indolent subtype of
mycosis fungoides. It affects mainly men between the third and fourth decades.
It is characterized by hardened and erithematous plaques that mainly affect
flexural areas and become pedunculated after some years. Histological
examination shows a dense infiltrate of small atypical lymphocytes involving the
dermis (and sometimes the subcutaneous tissue) associated with histiocytic and
multinucleated giant cells containing lymphocytes and elastic fibers
(lymphophagocytosis and elastophagocytosis, respectively). Patients affected by
this entity can develop secondary lymphomas. There are several but little
effective therapeutic modalities described. Despite the indolent behavior of
granulomatous slack skin, its early recognition and continuous monitoring by a
dermatologist becomes essential for its management and prevention of an
unfavorable outcome.
The "racket" lesion is a rare presentation of tuberculoid leprosy, which consists of
a thickened nerve branch emerging from a tuberculoid plaque. It results from
centripetal damage to cutaneous nerves caused by granuloma formation. We describe a
typical case of tuberculoid leprosy presenting as a "racket" lesion. The lesion
persisted after treatment with paucibacillary multidrug therapy.
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