Actinomycosis of the skin

Actinomycosis of the skin is the most common form of deep pseudomycosis. Pathogen-radiant fungi-actinomycetes. Depending on the pathway of infection, the skin distinguishes between primary and secondary actinomycosis. Their clinical manifestations are similar. When primary actinomycosis occurs exogenous infection (through skin lesions), with a secondary pathogen is brought into the skin from other affected organs by contact or lymphoma-hematogenous way.

Actinomycosis is more often localized in the submaxillary and sacro-gluteal regions. With the most frequent knotty (nodular-gummy) form, deep dense, slow-moving, painless, limited infiltrates are formed, which eventually acquire a cyanotic-red color, are abscessed and opened by several narrow fistulas. The process proceeds chronically with the scarring of old and the formation of new fistulas and daughter foci. The tubercle form is distinguished by a more superficial arrangement of small hemispherical foci, prone to serpiginating growth. Ulcerous forms occur with extensive abscessing of nodular infiltrates with the formation of irregular ulcers, having soft bluish undercut edges and an uneven bottom with necrotic coating and sluggish granulations.

Diagnosis is based on the clinical picture, the discovery of actinomycete druses with pus microscopy and the culture of the pathogen. Sometimes a pathohistological examination is required. The nodular-gummy form of actinomycosis is differentiated from syphilitic gum, scrofuloderm, and athere.

Treatment is carried out in accordance with the general principles of therapy of actinomycosis