History:

Case of Dr M Sokalingam

56 years old Chinese lady - works as a house maid
Presented with history of ulcer over the middle finger followed by multiple nodules spreading over the Left forearm to upper arm progressively.

Tender to touch / Not very itchy
Oozing from the ulcer over the Left middle finger
No history of fever /no history of cleaning fish tank

Was treated as bacterial infection by GP with Augmentin for 2 months - no improvement seen

dx : Sporotrichosis
Started on Sporonox with bactroban ointment for the ulcers

Review after one week - seen on the 3rd photo