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Cervicofacial actinomycosis mimicking lymphangioma circumscriptum
Mahendra M Kura1, Vrushali K Rane
1Department of Dermatology, Venereology and Leprosy, Grant Medical College and Sir J J Group of Hospitals, Mumbai, India .
Indian Journal of Dermatology
|July 21, 2011
Summary
Primary cutaneous actinomycosis, a rare Actinomyces israelii infection, typically presents as "lumpy jaw." This case highlights an unusual presentation mimicking lymphangioma circumscriptum, emphasizing the need for high suspicion for accurate diagnosis and effective penicillin treatment.
Area of Science:
- Dermatology
- Infectious Diseases
- Microbiology
Background:
- Primary cutaneous actinomycosis is a bacterial infection caused by Actinomyces israelii, most frequently affecting the cervicofacial region.
- Classic presentation includes 'lumpy jaw' with draining sinuses and characteristic sulfur granules.
- Diagnosis can be challenging due to low index of suspicion and the organism's fastidious nature, often delaying treatment.
Purpose of the Study:
- To report an atypical clinical presentation of cutaneous actinomycosis.
- To highlight diagnostic challenges and successful treatment outcomes.
- To emphasize the importance of considering actinomycosis in diverse dermatological presentations.
Main Methods:
- Case report detailing a patient with an unusual presentation of cutaneous actinomycosis.
- Histological confirmation of the diagnosis.
- Assessment of therapeutic response to penicillin.
Main Results:
- The patient presented with grouped papulovesicular and nodular lesions on the lower jaw, extending from the skin to the buccal mucosa, mimicking lymphangioma circumscriptum.
- Histopathology confirmed cutaneous actinomycosis.
- The patient showed an excellent therapeutic response to penicillin treatment.
Conclusions:
- Cutaneous actinomycosis can present atypically, challenging initial diagnosis.
- Prompt diagnosis and treatment with penicillin are crucial for favorable outcomes.
- Clinicians should maintain a high index of suspicion for actinomycosis in cervicofacial lesions, even with unusual presentations.
