Shivam Goyal; Sathish Ballambat Pai; Kanthilatha Pai
Abstract
Actinomycotic mycetoma or actinomycetoma is a type of mycetoma caused by Nocardia and Actinomyces. It usually affects the trauma-prone areas or extremities of the body. It is associated with characteristic discharging granules and sinuses. Gram staining of discharged granules shows thin Gram-positive ...
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Actinomycotic mycetoma or actinomycetoma is a type of mycetoma caused by Nocardia and Actinomyces. It usually affects the trauma-prone areas or extremities of the body. It is associated with characteristic discharging granules and sinuses. Gram staining of discharged granules shows thin Gram-positive filaments. Histopathology of granules shows suppurative granulomas composed of neutrophils surrounding characteristic grains. Several antibiotics are effective, including co-trimoxazole, dapsone, streptomycin, trimethoprim (TMP), rifampicin, and amoxicillin-clavulanic acid. However, co-trimoxazole remains the gold-standard therapy. Actinomycetoma of the scalp has been rarely reported. Here, we report the case of an Asian male in his 50s presenting with swelling over the scalp. It had developed seven years ago after a road traffic accident and remained elusive to treatment. There were no discharging sinuses or granules characteristic of actinomycetoma. The Gram stain and Modified Ziehl-Neelsen stain from superficial swabs were negative for pathogens. Bacterial and fungal cultures of the biopsy sample were inconclusive. However, histopathology showed epidermis having focal acanthosis overlying granulation tissue with proliferating capillaries, edema, and infiltration by lymphocytes, plasma cells, neutrophils, and eosinophils along with scattered foreign body giant cells. Filamentous bacterial colonies with surrounding neutrophils were present. These features were suggestive of actinomycetoma. The patient was treated with oral doxycycline and co-trimoxazole and had a complete regression of swelling after three months of follow-up. This case highlights an unusual morphology and location of actinomycetoma, which should be considered when encountering subcutaneous swelling.
Shivam Goyal; Smitha Prabhu S
Abstract
Genital herpes has superseded the bacterial sexually transmitted diseases (STD) as the most prevalent STD seen worldwide, with an estimated 491 million being affected. It is encountered with an increasing frequency, with a prevalence of 11.9% in the USA, and can present in atypical and severe ulcerative ...
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Genital herpes has superseded the bacterial sexually transmitted diseases (STD) as the most prevalent STD seen worldwide, with an estimated 491 million being affected. It is encountered with an increasing frequency, with a prevalence of 11.9% in the USA, and can present in atypical and severe ulcerative forms, especially in human immunodeficiency virus (HIV)-infected individuals. Though a definitive antiviral treatment with acyclovir, valacyclovir or other derivatives exists, the property of latency and reactivation leads to its increasing incidence and prevalence. The common sites of involvement in the males are the glans, prepuce, and shaft of the penis. The male condom, if used appropriately, is the most effective among the barrier methods of contraception, with an additional advantage of protection from STDs. However, it has a failure rate of up to 13%. The efficacy of condoms in preventing herpes simplex virus 2 (HSV-2) transmission has been studied in several contexts; condoms are often associated with a decreased risk of HSV-2 transmission, yet fallacies can occur. Here, we describe a male who developed a primary episode of genital herpes at the base of the penis, despite proper usage of condoms during intercourse. This presentation can be likened to condom chancre, a much-described entity of primary syphilis.
Shivam Goyal; Smitha S Prabhu; M Mukhyaprana Prabhu
Abstract
At present, the whole world is going through the coronavirus disease 2019 (COVID-19) pandemic, which is taking its toll on healthcare workers (HCWs) as well as patients. In fact, HCWs are not only at risk of acquiring the disease but also suffer from various problems related to prolonged work in a stressful ...
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At present, the whole world is going through the coronavirus disease 2019 (COVID-19) pandemic, which is taking its toll on healthcare workers (HCWs) as well as patients. In fact, HCWs are not only at risk of acquiring the disease but also suffer from various problems related to prolonged work in a stressful situation with full personal protective equipment (PPE), which may lead to adverse cutaneous effects We used search engines to look for data on the dermatological problems in HCWs owing to frequent handwashing and to the use of PPE. The search terms used were ‘COVID-19’, ‘healthcare worker’, ‘dermatoses’, ‘personal protective equipment’, and ‘hand hygiene.’
Healthcare workers are susceptible to various dermatoses caused by multiple confluent factors including working for long hours in PPE, which is usually snug-fitting and includes headgear, masks, goggles, gloves, boot covers, and surgical gowns. They also are subjected to frequent hand cleansing, often more than 20 times a day. All this has led to various dermatoses caused by friction, pressure, humidity, irritation, as well as allergic responses to the equipment used in almost all those who work for prolonged periods in PPE, as shown by various case series and reports. Steps are being formulated to minimize these adverse cutaneous effects through appropriate measures that must be taken by HCWs. Healthcare workers are susceptible to various dermatoses caused by excessive hand hygiene practices and prolonged usage of PPE.
Proper counseling minimizes the morbidity by promoting protective measures.
