Cutaneous Manifestations of Brucellosis

Abstract

Aim.To present and compare 10-year clinical experience of human brucellosis in Republic of Macedonia with data presented in the literature about the frequency of cutaneous manifestations of brucellosis. To estimate the percent of underdiagnosed / misdiagnosed skin lesions related to brucellosis and to raise awareness of cutaneous manifestations of brucellosis in our clinical practice. Methods.Clinical records and experience of the Infectious Diseases Clinic and Dermatology Clinic, Faculty of Medicine, Skopje, and a review of the recent literature data about cutaneous manifestations of brucellosis relevant for dermatologists, infectologists and general practitioners. Results.Cutaneous manifestations or complications have been reported rarely, less than 5% (3.8 % -17 %) in different published studies. A variety of skin lesions have been reported in patients with brucellosis, including rashes (25%), nodules, papules, erythema nodosum (25%), eczematous lesions (12.5%), psoriasiform lesions (12.5%), petechiae, purpura and others.

Ulcerative Lesions: A Rare Cutaneous Manifestation of Brucellosis

“…Chronic skin ulceration is one of the complications of brucellosis [ 19 ]. Balabanova-Stefanova et al summarized and classified various cutaneous manifestations of brucellosis in a table in their review article, indicating that skin ulcers resulting from brucellosis are sporadic [ 20 ]. In the patient described in the present article, the cutaneous manifestations in the form of the ulcerative lesions were painful and had involved both hands due to occupational contact.…”

Skin Manifestations Associated with Brucellosis

“…Hypersensitivity phenomena, deposition of immune complexes in the skin, and granuloma formation may cause the cutaneous manifestations observed during the chronic phase of the disease. 18,19,34…”

“…18 Skin involvement is reported to range between 0.4% and 17.0%. 2,10,13,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] It is rare and the lesions are not specific to brucellosis. 19 Due to its non-specific nature and rarity, in this review we evaluate misdiagnosed skin involvement associated with brucellosis and raise awareness about this manifestation of brucellosis.…”

<p>A rare case of brucellosis with dermatomal pattern of cutaneous manifestation</p>

“…Brucellosis is a systemic disease and systemic infection may involve any organ or system of the body such as reticuloendothelial system (spleen, liver, bone marrow, and lymph nodes), gastrointestinal, central nervous system, cardiovascular, musculoskeletal, genitourinary, and integumentary systems 6,7. Cutaneous involvement has also been described for brucellosis, but it is uncommon and unspecific 8. Manifestations of cutaneous involvement have been described mostly as disseminated papulonodular eruption, erythema nodosum-like lesions, diffuse maculopapular rash, maculopapular eruptions, psoriasiform lesions, palmar erythema, malar eruption, and palmar eczema 9–11.…”