This protocol covers the first-line management of sporotrichosis presenting as cutaneous or lymphocutaneous disease — the most common clinical forms seen in practice, with lymphocutaneous sporotrichosis being the predominant presentation.
Patients present with cutaneous sporotrichosis or lymphocutaneous sporotrichosis, the latter characterised by skin lesions with spread along the lymphatic channels. This protocol is designed for these superficial presentations and provides specific guidance on the appropriate therapeutic approach for each.
Management centres on a targeted antifungal agent administered for a defined period extending beyond apparent lesion resolution. The specific agent, dosing schedule, and duration criteria are set out in the full protocol.
Complete drug selection, dosing, and course-length criteria are available in the full structured regimen below.
The primary target is clinical improvement of cutaneous lesions, which is often evident within 4 weeks of starting therapy, with the endpoint being complete resolution of all lesions.
DOI: 10.1086/522765
For cutaneous and lymphocutaneous sporotrichosis, itraconazole (200 mg orally daily) is recommended to be given for 2–4 weeks after all lesions have resolved, usually a total of 3–6 months (A-II).
Clinical improvement is often manifested within 4 weeks after starting therapy, and only a small number of patients need higher dosages of itraconazole or therapy with other antifungals.
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