The treatment of choice for cutaneous sporotrichosis until recently was potassium iodide (SSKI) 3 to 4 g three times a day to be continued for at least 1 month beyond resolution of clinical symptoms. This was a cumbersome treatment and was associated with a high incidence of side effects such as metallic taste, anorexia, and swelling of the salivary glands. Recently, itraconazole (100-200 mg qd for 3-6 months) has been shown to be a highly effective and much better tolerated treatment for localized as well as many systemic forms of sporotrichosis.13 Fluconazole has been shown to be less effective than itraconazole and should be reserved for those few patients not tolerating itraconazole. Ketoconazole has shown even poorer results than fluconazole. Intravenous amphotericin B is effective, but adverse reactions usually limit its use to disseminated forms.
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