American Board of Internal Medicine (ABIM) Certification Practice Exam

Which antifungal medication is recommended for the treatment of cutaneous sporotrichosis?

1. Itraconazole

2. Fluconazole

3. Ketoconazole

4. Amphotericin B

The correct answer is: Itraconazole

Itraconazole is the recommended antifungal medication for the treatment of cutaneous sporotrichosis due to its effectiveness against the fungus Sporothrix schenckii, the causative agent of this infection. This medication is a triazole antifungal and works by inhibiting the synthesis of ergosterol, a vital component of fungal cell membranes, thereby leading to the death of the fungal cells. Itraconazole is known for its high oral bioavailability and suitable pharmacokinetic profile, making it an excellent first-line treatment for sporotrichosis. In patients with cutaneous sporotrichosis, itraconazole not only helps to alleviate symptoms but also reduces the risk of progression and dissemination of the infection. Fluconazole is generally effective against certain fungal infections, particularly those caused by Candida species and Cryptococcus, but it's not the drug of choice for sporotrichosis. Ketoconazole is less frequently used today due to its side effects and lower efficacy compared to newer antifungals like itraconazole. Amphotericin B is typically reserved for more severe systemic fungal infections, rather than localized cutaneous infections. Therefore, itraconazole stands out as the most appropriate and effective therapy for cutaneous sporotrichosis in clinical