Lymphocutaneous sporotrichosis involves secondary lesions (papules that are not very painful and often ulcerate) developing along lymphatic channels proximally from the initial site of inoculation. Other presentations include a fixed lesion (verrucous or ulcerative) at the initial site of inoculation without lymphatic spread, osteoarticular disease (chronic synovitis or septic arthritis in alcoholics), pulmonary disease (most common among pts with chronic obstructive pulmonary disease), and disseminated disease (numerous skin lesions with occasional spread to visceral organs in immunocompromised pts).