Madura foot in a non-endemic setting: surgical management and reconstruction with skin graft

Mycetoma is an uncommon, chronic, granulomatous infectious condition that affects the skin, dermis and subcutaneous tissues. It is prevalent in tropical and subtropical areas. The patient presented to our hospital with a left foot lesion that he first noticed 2 years ago. The lesion consisted of multiple pits discharging black granules and pus. Culture revealed that the grains comprise a mass of fungal hyphae organised within a deeply eosinophilic amorphous matrix (Splendore-Hoeppli material). The patient received multidrug therapy, radical excision of mycetoma and a skin graft. He responded well to treatment. Because the diseases progress slowly, most patients are often diagnosed at a later stage. Therefore, focusing on health education and the significance of wearing footwear is essential.