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What Culprit Hidden in This Gardener's Back Yard Caused These Deep, Scaly Nodules?

What Culprit Hidden in This Gardener's Back Yard Caused These Deep, Scaly Nodules?

A 58-year-old gardener suffered many deep scratches while tending to his backyard rose bushes. Several weeks later, he developed multiple, indurated, slightly scaly, deep dermal to subcutaneous nodules on the hand. He also noted gradual tender swelling in the ipsilateral axilla. Overall review of systems was benign, as was the past medical and family history. The patient was not taking any medications. His wife and a young adult child still living at home were free of similar findings.

Which of the following interventions is considered the treatment of choice for this patient’s condition?
A. Oral griseofulvin
B. Cryosurgery
C. Oral ketoconaozle
D. Oral itraconaozle
E. Intravenous amphotericin B

 Answer on the next page

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