Dermoscopic features of actinomycetoma: a case series

Abstract

Dermoscopy of mycetoma has white structures as the predominant feature, while white scale and yellowish structures were also consistent in our findings with available literature.

Dermoscopy aids in lesion selection for microbiological and histopathological assessment of mycetoma

“…Mycetoma is a chronic granulomatous infection of the skin and the subcutaneous tissue that is caused by bacteria (actinomycetoma) or fungi (eumycetoma). [ 1 2 4 ] It is characterized by a triad of painless woody swelling, sinus formation, and seropurulent discharge with grains. [ 4 ] It most commonly presents unilaterally affecting a foot, but other body areas such as the trunk can be involved as well.…”

“…[ 1 2 4 ] It is characterized by a triad of painless woody swelling, sinus formation, and seropurulent discharge with grains. [ 4 ] It most commonly presents unilaterally affecting a foot, but other body areas such as the trunk can be involved as well. [ 4 5 ] The diagnosis of mycetoma can be made clinically; however, an accurate diagnosis of either actinomycetoma or eumycetoma requires more sophisticated steps such as assessment of grains color, Gram staining, and culture of the grains or exudate as well as skin biopsy for histopathological evaluation and special staining.…”

“…[ 1 2 5 ] It can also be used as a guide in lesion selection for skin biopsy by visualizing tiny grains. [ 2 4 5 ] Dermoscopic examination of actinomycetoma may show white structures, white scales, erythema, yellowish or black structures, hyperpigmentation, arborizing, and dotted vessels. However, it may show yellow globules, red structureless areas, white scales, and dotted vessels in eumycetoma.…”

“…However, it may show yellow globules, red structureless areas, white scales, and dotted vessels in eumycetoma. [ 4 5 ] The utility of dermoscopy may extend beyond diagnosis to aid in monitoring response to treatment where there would be decrement in white and red areas. [ 5 ] In our case, dermoscopy showed white grains alike those in actinomycetoma and occasionally in eumycetoma, suggesting that it may not be possible to distinguish actinomycetoma from eumycetoma dermoscopically.…”

“…[ 2 ] Few published reports document the utility of dermoscopy in diagnosing mycetoma. [ 1 2 3 4 ] Herein, we present the dermoscopic findings of mycetoma, which helped in selecting skin lesions from which both grains and skin biopsy were obtained to support the diagnosis of mycetoma. This subject may be of particular importance to the primary healthcare physicians and dermatologists working in rural areas, where repeating procedures may lead to unnecessary costs for both patients and healthcare facilities.…”