trimethoprim--sulfamethoxazole-drug-combination and Leg-Dermatoses

Topics: Aged; Anti-Bacterial Agents; Diagnosis, Differential; Drug Eruptions; Female; Humans; Leg Dermatoses; Purpura; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Tract Infections; Vasculitis, Leukocytoclastic, Cutaneous

We report three adult cases of very chronic, extensive infection of the lower limbs due to Mycobacterium marinum. The patients were from South Pacific islands and, clinically, the widespread warty plaques resembled chromomycosis. One was associated with severe lymphoedema. All three patients gave a history of at least 20 years duration. The patients were otherwise well and not immunologically compromised. In all cases, the organism was identified on tissue cultures and was not seen on histopathology. The mycobacteria were sensitive to most antibiotics tested in vitro. The patients were treated with a combination of rifampicin and cotrimoxazole with good results.

Topics: Adult; Aged; Anti-Bacterial Agents; Antibiotics, Antitubercular; Chromoblastomycosis; Chronic Disease; Culture Techniques; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Leg Dermatoses; Lymphedema; Male; Mycobacterium Infections, Nontuberculous; Mycobacterium marinum; Pacific Islands; Rifampin; Time Factors; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Nocardiasis is caused by a germ belonging to the Actinomycetales order. Skin disease usually occurs as a secondary localization of a pulmonary infection in an immunocompromised patient. Purely cutaneous lesions usually occur in immunocompetent subjects.. We observed primary cutaneous nocardiasis due to N. asteroides with a cold abscess in a patient with a pemphigoid given immunodepression treatment.. Primary cutaneous nocardiasis can occur by direct contamination of a skin wound. In our patient with a pemphigoid given immunodepression treatment, the erosion of a pemphigoid bulla and general corticosteroid treatment favoured the localized infection. Cure could not be obtained until after 7 months treatment. This long course can be explained by the need to continue high-dose general corticosteroids to control the pemphigoid.

Topics: Aged; Humans; Immunocompromised Host; Leg Dermatoses; Male; Nocardia asteroides; Nocardia Infections; Pemphigoid, Bullous; Prednisone; Skin Diseases, Bacterial; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Aged; Drug Combinations; Drug Eruptions; Drug Interactions; Female; Humans; Leg Dermatoses; Methotrexate; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination