Other diagnoses include cutaneous leishmaniasis, as occurred for 2 of the soldiers, as well as diffuse leishmaniasis, chromomycosis, sporotrichosis
, lepromatous or tuberculoid dimorphic leprosy, mycetoma, phaeohyphomycosis, pyoderma, Kaposi sarcoma, sarcoidosis, keloid scars, histiocytosis of Langerhans cells, melanoma, dermatofibrosarcoma, lymphoma, squamous cell carcinoma, and cutaneous metastases (3,17,40,41).
Differential diagnoses at this stage based on the hard facial swelling was tooth root abscess, nasosinal or maxillary gingival neoplasia (such as fibrosarcoma, adenocarcinoma, lymphoma) while presence of unilateral hemopurulent ocular and nasal discharges were suspicious for a more granulomatous disease such as sporotrichosis
, cyptococcosis, aspergillosis or foreign body induced inflammatory granuloma.
Differential diagnoses include, depending on the phase of the disease, anthrax, atypical mycobacteriosis, cowpox, pseudocowpox (Milker's nodule), pyoderma, herpetic whitlow, tularemia, keratoacanthoma, fish-tank granuloma, and sporotrichosis
[1, 2, 8].
Infections that can mimic PG include atypical mycobacterial ulcers, cutaneous tuberculosis, cutaneous leishmaniasis, sporotrichosis
, and other deep fungal infections shown in Table 2 [6, 14, 17].
N Classification of cutaneous Diagnostic considerations tuberculosis 1 Exogenous Tuberculosis sporotrichosis
, leishmaniasis, cutaneous chancre atypical mycobacteriosis, Tuberculosis syphilis, cat scratch disease and tularemia Tuberculosis paracoccidioidomycosis, verrucosa cutis leishmaniasis, sporotrichosis
, tuberculosis verrucosa and chromomycosis.
Amphotericin B is the preferred drug for disseminated/severe fungal diseases including cryptococcosis, coccidioidomycosis, paracoccidioidomycosis, histoplasmosis, blastomycosis, mucormycosis (zygomycosis) for induction therapy, and sporotrichosis
is a rare disease caused by Sporothrix schenckii .
Common clinical differential diagnoses of skin TB include cutaneous leishmaniasis, leprosy, atypical mycobacterial infections, fungal infections like chromomycosis and sporotrichosis
The Sporothrix schenckii, causal agent of sporotrichosis
is dimorphic fungus, of saprophytic life in soil or plants occasionally infecting people and animals.
Other diseases presenting as discharging sinuses in children are actinomycosis, botryomycosis, nocardiosis, and sporotrichosis
. Sinuses of actinomycosis and nocardiosis usually discharge granules; botryomycosis is associated with subcutaneous nodules and large verrucous lesions; and in sporotrichosis
, ascending chain of nodules develops along the skin lymphatic channels.
In this study, we used 22 serum samples from patients with the chronic form of paracoccidioidomycosis (PCM), 12 with histoplasmosis (H), 12 with aspergillosis (A), 2 with sporotrichosis
(S), and 8 with tuberculosis (Tb).
Hence, they may be confused with TB verrucosa cutis, leprosy, squamous cell carcinoma, sporotrichosis
, and palmar-plan tar psoriasis.