Background

Mycetomas are chronic but localized infections of the skin, usually secondary to local penetrating trauma. It has broadly been divided into two types depending upon the organism. These infections may extend into muscle and bone. The usual signs and symptoms include edema, draining sinus tracts, and granule formation with extrusion.

OUTLINE

Epidemiology
Disease Associations
Pathogenesis
Laboratory/Radiologic/ Other Diagnostic Testing
Gross Appearance and Clinical Variants
Histopathological Features and Variants
Special Stains/ Immunohistochemistry/ Electron Microscopy
Differential Diagnosis
Prognosis
Treatment
Commonly Used Terms
Internet Links

 

EPIDEMIOLOGY	CHARACTERIZATION
GEOGRAPHY	Tropics and subtropics

 

PATHOGENESIS	CHARACTERIZATION
Eumycotic (Fungus)	Madurella mycetoma Madurella frisea Allescheria boydii Petrellidium boydii (Most common organism causing mycetoma in the USA)
Actinomycotic (Filamentous bacteria)	Actinomyces Streptomyces

 

HISTOLOGICAL TYPES	CHARACTERIZATION
General	Areas of suppuration with histiocytes Granules are located in the center of the areas of suppuration
VARIANTS

 

SPECIAL STAINS/ IMMUNOPEROXIDASE/ OTHER	CHARACTERIZATION
Special stains	Fungal mycetomas are GMS and PAS positive Actinomycetomas are gram positive

J Am Acad Dermatol 1982;6:107-111
Int J Dermatol 1984;23:221-236
Henry JB. Clinical Diagnosis and Management by Laboratory Methods. Twentieth Edition. WB Saunders. 2001.
Rosai J. Ackerman's Surgical Pathology. Ninth Edition. Mosby 2004.
Sternberg S. Diagnostic Surgical Pathology. Fourth Edition. Lipincott Williams and Wilkins 2004.
Robbins Pathologic Basis of Disease. Seventh Edition. WB Saunders 2005.
DeMay RM. The Art and Science of Cytopathology. Volume 1 and 2. ASCP Press. 1996.
Weedon D. Weedon's Skin Pathology Second Edition. Churchill Livingstone. 2002
Fitzpatrick's Dermatology in General Medicine. 5th Edition. McGraw-Hill. 1999.
Weiss SW and Goldblum JR. Enzinger and Weiss's Soft Tissue Tumors. Fourth Edition. Mosby 2001.

Basic Principles of Disease
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Commonly Used Terms
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Diagnostic Process
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Surgical Pathology Report
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Last Updated 1/5/2004

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