Digital nodules and pustules in a patient with Crohn disease

Abstract

A 55-year-old cachectic (BMI 16.7 kg/m 2 ) man with known Crohn disease as well as long-standing immunosuppressive therapy and alcohol abuse developed fi rm subcutaneous nodules and pustules two years after an injury to the right index fi nger. These extended over the entire index fi nger, the palm and from the dorsum of the hand to the dorsomedial forearm and were associated with burning pain and reduced function ( Figure 1). Histopathology findingsHistology revealed neutrophilic infl ammation with pustules and abscesses (Figure 2). A further biopsy additionally detected drusen with amorphous concretions and chronic neutrophil-rich granulomatous infl ammation (Figure 3). Isolation of a pathogen from pus or tissue was not possible.

Eumycetoma and actinomycetoma – an update on causative agents, epidemiology, pathogenesis, diagnostics and therapy

“…Botryomycosis represents a mycetoma‐like infection of the skin due to staphylococci and/or streptococci, and might also develop in people living in Europe and North America . Histologically, botryomycosis shows a granulomatous inflammation with grain‐like amorphous structures …”

“…53,54 Histologically, botryomycosis shows a granulomatous inflammation with grain-like amorphous structures. 55 2) Non-infectious diseases: Mossy-Foot or podoconiosis, malignant tumours, like sarcoma of the skin and soft tissue or bones, endemic and epidemic Kaposi 0 s sarcoma. 56 In the mycetoma belt endemic Kaposi 0 s sarcoma is more frequent than the epidemic form of Kaposi 0 s sarcoma, which is associated with HIV/AIDS.…”