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Actinomycosis of the Skin


A chronic, spreading suppurative and granulomatous disease primarily caused by the gram-positive anaerobic bacteria Actinomyces israelii. Several clinical types can be recognized. CERVICOFACIAL ACTINOMYCOSIS, the commonest form, initially presents as a dull-red indurated nodule on the cheek or submaxillary region. Multiple sinuses, puckered scarring and the formation of new nodules produce an uneven lumpy surface. Fistulas or even small ulcerations arise. Characteristic sulphur granules may be found in the discharging pus. Massive, hard aggregates arise. THORACIC ACTINOMYCOSIS and ABDOMINAL ACTINOMYCOSIS cause general symptoms such as fever, chills, night sweats and weight loss. Skin involvement arises as a secondary effect. PRIMARY CUTANEOUS ACTINOMYCOSIS is very uncommon. Subcutaneous nodules usually occur on the exposed skin, extend slowly and break down to form sinuses.




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