Rose thorn injury

Description

A 71-year-old man, with a history of arterial hypertension, presented with a 4-month history of four painful progressively enlarging nodules on the dorsal aspect of the right hand. The patient reported that he had been pricked by a rose on the fourth finger approximately 3 weeks before the appearance of the first lesion on the site of the injury. On physical examination, we observed four erythematous nodules, 10–15 mm in diameter, in linear distribution extending from the hand proximally (figure 1). Two nodules presented superficial erosions with purulent secretion. No systemic symptoms were detected. Histopathology revealed epidermal hyperkeratosis and suppurative small granulomas with polymorphous dermal infiltrate and periodic acid-Schiff staining identified rare fungal spores (figure 2). Culture from the biopsy specimen was negative. Clinical presentation and histology were consistent with sporotrichosis, so the patient was given itraconazole 200 mg daily. After 3 months of treatment,...

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