Mycobacterial skin infection

Abstract

Purpose of review The aim of this article is to review the most recent evidences concerning mycobacterial skin infections, limiting the period of literature research to 2020--2021. Recent findings Mycobacterial skin infections include a heterogeneous group of cutaneous diseases. Cutaneous tuberculosis is usually the result of hematogenous dissemination or spread from underlying foci and it must be distinguished from tuberculids, resulting from the immunological reaction to Mycobacterium tuberculosis antigens. Leprosy prevalence was drastically reduced after introduction of multidrug therapy in the 1980 s, but cases are still reported due to underdiagnosis, and animal and environmental reservoirs. Recent advances concentrate in the diagnostic field. Specific guidelines for the treatment of nontuberculous mycobacteria skin infections are missing and surgical procedures may be required. Prognosis is better as compared to nontuberculous mycobacteria lung disease. Rapid laboratory-confirmed diagnosis of Buruli ulcer may be achieved by the IS2404 PCR. Among new drugs, telacebec is promising in terms of potency, shorter duration and tolerability in animal studies. A clinical trial in humans is planned. Summary Mycobacterial cutaneous lesions are nonpathognomonic and clinical suspicion must be confirmed by culture or molecular detection. Long-course multidrug treatment is required based on susceptibility tests. Surgical intervention may also be required. Rehabilitation and psychosocial support reduce long-term physical and mental consequences mostly in Buruli ulcer and leprosy.

Cutaneous Deep Ulcerations as Initial Presentations of Granulomatosis with Polyangiitis: Two Case Reports and Differential Diagnosis

“…Mycobacterium tuberculosis cutaneous lesions are nonpathognomonic, but deep ulceration is rare. A study showed that BCG vaccination or immunotherapy may be correlated with local cutaneous complications, such as nonhealing ulcers and localized abscesses [ 21 ]. Additionally, visceral tuberculosis is rarely associated concurrently with cutaneous involvement [ 22 ].…”

Mycobacterium abscessus sporotrichoid infection after a dog bite

“… 1 They were first described in 1931 by Pinners, and there are now more than 200 reported species. 3 M. abscessus is associated with a wide spectrum of dermatological lesions that include cellulitis, abscesses, papules, pustules, fistulae, ulcers, necrotic lesions, and subcutaneous nodules that can resemble Sporothrix lesions. 2 , 3 …”

Cutaneous non-tuberculous mycobacterial infections: An update

“…[54] TREATMENT Recommended treatment for the various NTM species is given in Table 1. [2,7,41,[55][56][57] In general, antibiotic susceptibility should be performed in all RGM species because of unpredictable resistance patterns. [3] Inducible macrolide resistance encoded by erm(41)/erm (39) gene is of particular concern.…”

“…ere are isolated reports of use of omadacycline in the treatment of cutaneous infections due to NTM. [55] Avibactam, a novel beta-lactamase inhibitor can restore susceptibility to betalactams in resistant M. abscessus strains. [7] CONCLUSION Skin infections caused by NTM are challenging in many ways, from non-specific presentations, difficulty in microbiological diagnosis, lack of well-defined treatment guidelines, and varying patterns of antimicrobial resistance.…”