Case Report. Lymphatic vessel-type sporotrichosis: immunohistochemical evaluation and cytokine expression pattern

A 57-year-old male carpenter living in Sagamihara, Kanagawa Prefecture, vis ited the Department of Dermatology of Kitasato University Hospital because an ulcer which appeared in his left forearm around May 1992 had spread grad ually. An oval, shallow ulcer measuring 39 mm x 18 mm was found on the flex or aspect of the left forearm. Histopathological examination showed partial ulceration on the epidermis and marked cell infiltration throughout the en tire dermal layer with an abscess in the centre and granulomatous reactions around it. PAS-positive spores were present between infiltrating cells and in giant cells in abscess and in granulomatous reactions. The skin lesion rapidly disappeared I after beginning treatment with 125 mg day(-1) terbina fine and only a slight redness remained 14 weeks after starting the treatme nt. At this time the culture was negative. We conducted immunohistochemical examinations of the affected skin before, during and after starting treatm ent with terbinafine and studied local expression of cytokines at the affec ted lesion.