Which antifungal is commonly used to treat sporotrichosis?

• A. Itraconazole
• B. Fluconazole
• C. Voriconazole
• D. Ketoconazole

Answer: (B)

Sporotrichosis responds best to a drug with strong activity against Sporothrix schenckii and good distribution into skin and subcutaneous tissues. Itraconazole fits this role as the preferred first-line therapy for cutaneous and lymphocutaneous forms. A typical plan is around 200 mg twice daily (or 200 mg daily in some guidelines) for 3 to 6 months, sometimes longer depending on response, with gradual resolution of lesions as the infection clears. The antifungal works by inhibiting ergosterol synthesis in the fungal cell membrane, weakening the membrane and allowing the organism to be controlled and eventually eliminated.

Fluconazole is less effective against Sporothrix and is not considered first-line; it may be used if itraconazole cannot be given. Other azoles like voriconazole or ketoconazole are not preferred due to variable activity or potential side effects. In more severe or disseminated cases, initial treatment with amphotericin B may be needed, followed by itraconazole for consolidation.