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[Cutaneous actinomycosis in the perianal area and buttocks]
A Gayraud1, C Grosieux-Dauger, A Durlach
1Service de Dermatologie, CHU Robert-Debré, Reims, France.
Introduction:
Actinomycosis is a rare spreading suppurative and granulomatous disease. In 50 to 60 p. 100 of cases, cervico-facial area is involved. Involvement of other cutaneous areas is very uncommon.
Case-Reports:
Two men (51 and 58 year-old, respectively) were admitted to the hospital because of erythematous and violaceous nodules with fistulization to the skin, localized on the perianal area and buttocks for several months. Bacterial cultures of the pus and of skin biopsy specimens yielded Actinomyces meyeri in case 1 and Actinomyces israelii in case 2. Patients did not have other infectious lesions. Treatment included systemic antibiotics and surgical iterative excisions in case 1.
Discussion:
The main interest of those two cases is their similar clinical presentation and in one case the rarity of the micro-organism involved (Actinomyces meyeri). Since the lesions involved only the skin, we postulate that the organism may have extended from the oral mucosa through the gastrointestinal tract.
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