Sporotrichosis is a subacute or chronic fungal infection caused by the Sporothrix schenckii species complex, a dimorphic fungus found in soil, plants, and organic matter [1]. Traditionally, sporotrichosis has been associated with environmental exposure. However, in recent years there have been increasing reports of zoonotic transmission, predominantly through scratches or bites from infected cats [2]. This mode of transmission has become more prevalent in Thailand, where a rising number of cases have been documented [[3], [4], [5]].

Clinically, sporotrichosis often presents as nodules or plaques along the lymphatic drainage, leading to the characteristic lymphocutaneous form if multiple nodules appear along the path of the lymphatics [6]. Most infections, particularly in immunocompetent individuals, respond well to antifungal treatment which is typically itraconazole and resolve without severe complications [7]. Still, in some instances, chronic or inadequately treated cutaneous sporotrichosis can manifest in verrucous or hyperplastic variants, mimicking squamous cell carcinoma (SCC). A notable example of benign epidermal proliferation that can clinically and histopathologically resemble SCC is pseudoepitheliomatous hyperplasia (PEH), posing a significant diagnostic challenge [8,9]. Rarely, sporotrichosis may indeed progress to SCC, although only a few such cases have been described [10,11].

Here, we present a case of lymphocutaneous sporotrichosis in which a chronic plaque initially raised concern for malignant transformation. Upon thorough histopathological review, the lesion was confirmed to be PEH rather than true SCC. This case underscores the importance of early diagnosis, comprehensive histopathological evaluation, and awareness of sporotrichosis variant, particularly in patients with prolonged or atypical cutaneous lesions.