Atypical mycobacterial infection

Question 1

Atypical, mycobacterial infection

Answer 1

Question 2

Mycobacterium Marinum

Answer 2

M. marine = fresh and saltwater; small cuts or abrasions

Violaceous plaque along the afferent lymphatics - sporotrichoid pattern

Diagnosis is clinical

Also called ‘fish tank granuloma’

Question 3

Cutaneous larva migrant

Answer 3

Serpiginous cutaneous eruption

Penetration and migration of hookworm larvae through epidermis

Caused by larvae of hookworms (Ancylostoma carinum, A. brazilense and uncinaria stenocephala)

Commonest in SE US, central and south America, Africa

Localised intense pruritus, rash few days later

Larva migrates 1-2cm/day

Commonest sites lower limbs and buttocks

Clinical diagnosis

Tx = usually self-limiting, can treat with cryotherapy

Question 4

Larva current “racing larva”

Answer 4

Strongyloids stercoralis - nematode that can complete its life cycle in human

Similar to larva migrant appearance but more likely in thighs, buttocks, perineum

Question 5

Cutaneous Tuberculosis

Answer 5

M. Tuberculosis

Systemic ID that can affect any organ system, including skin

5-10% infections lead to clinical disease

Histopathological hallmark = caveating granuloma, giant cells

Question 6

Leishmaniasis

Answer 6

Question 7

Leprosy

Answer 7