Ghaus Qureshi, Zarnaz Wahid, Anjum Kanjee.
Primary Cutaneous Actinomycosis A Study of 5 Cases.
J Pak Assoc Derma Jan ;11(1):32-5.

5 cases of primary cutaneous actinomycosis were studied over a period of 5 years. Primary cutaneous actinomycosis is very uncommon because of the endogenous habitat of the organism. It is characterized by the formation of nodules and discharging sinuses usually on exposed areas of the body. This disease causes considerable therapeutic problems and is refractory to therapy.

CASE REPORTS: 5 Case of primary cutaneous actinomycosis were studied during a period of 5 years a the Dermatology Department of Jinnah postgraduate Medical Center and Civil Hospital Karachi. 3 of these patients were male while 2 patients were female. The age range was between 25-40 years with mean age being 31. 20 years. The lower limb was involved in 2 patients, upper limb in one patient, buttock and scrotum in one patient and one patient had a disseminated disease involving the limbs and trunk. All patients presented with nodules and discharging sinuses. There was no systemic involvement in any of these patients. The patients were followed for 2 years except one case who was lost to follow-up after 6 month The investigations performed in our patients included, Blood CP, ESR, X-Ray Chest, urine D/R, serum electrolytes, blood urea, serum Creatinine, Barium studies XRay of the underlying bone, LFTs and blood Sugar levels. The diagnosis of out patients was based on finding the characteristic yellow sulphur granules in the discharging material. These granules were crushed and stained to reveal the gram-positive branching filament of actinomyces. These granules are the colonies of the organisms which are held together by calcium phosphate of host origin. Skin biopsy was also performed which showed the typical dark actinomycotic colonies on H&E stains. The eosinophilic colonies of actinomyces seen on H&E stained tissue sections can be differentiated from fungal colonies and bacterial colonies of botromycosis by performing special stains like PAS, gram stain and Grocott stain. Culture was performed anaerobically on sheep blood agar.

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