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Primary cutaneous actinomycosis of the lower extremity: A clinical dilemma.

Sonam Sharma, Rachit Sharma, Sansar C Sharma

Actinomycosis is an indolent suppurative and granulomatous infection caused by anaerobic or microaerophilic bacteria, primarily of the genus Actinomyces that normally colonize the mouth, colon, and vagina. It is characterised by contiguous spread, formation of multiple abscesses, discharging sinuses draining sero-sanguinous fluid and sulphur granules followed by fibrous tissue formation. It typically involves the head and neck, thorax, abdomen and pelvic region of the body. Primary cutaneous actinomycosis of the lower extremity is a rare event to occur and can be easily misdiagnosed clinically. A high index of suspicion, clinical and histopathological examination as well as isolation and culture of the organism is required for its definite diagnosis. We herein describe a rare case of a 55- year-old Indian woman who had primary cutaneous actinomycosis of the right lower leg and foot which posed a diagnostic as well as therapeutic challenge.