title: Dormant primary cutaneous actinomycosis: Acute exacerbation after 16 years.
abstract: Actinomycosis of head and neck are secondary to a nidus in the oral cavity and the aero-digestive tract. Primary actinomycosis without such predisposition is mostly due to trauma. We are presenting a case of this rare variant involving the forehead. The patient had a swelling over the forehead after a windscreen injury, which was asymptomatic for 17 years. However, 1 year ago, there was a repeat blunt trauma on the same site, but there was no breach of skin. Following this, the swelling became tender and started increasing in size. There was no response to a course of antibiotic and the patient had no concomitant history of any systemic illness. The swelling was excised and the biopsy revealed actinomycosis. This presentation of primary actinomycosis after such a long dormancy has never been reported before. This is yet another unusual presentation of actinomycosis, which is notoriously misdiagnosed owing to its rarity and numerous differential diagnoses.
authors.affiliation: Department of Plastic Surgery, Postgraduate Institute of Medical Education & Research and Dr. R.M.L. Hospital, New Delhi 110001, India. lalitmakhija@yahoo.com
authors.forename: Lalit K
authors.initials: LK
authors.lastname: Makhija
authors.forename: Manoj K
authors.initials: MK
authors.lastname: Jha
authors.forename: Sameek
authors.initials: S
authors.lastname: Bhattacharya
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Bhardwaj
authors.forename: Ashish
authors.initials: A
authors.lastname: Rai
authors.forename: Sharad
authors.initials: S
authors.lastname: Mishra
mesh_terms: D000196:Actinomycosis / Q000175:diagnosis* / Q000628:therapy; D005546:Forehead; D006801:Humans; D008297:Male; D012008:Recurrence; D017192:Skin Diseases, Bacterial / Q000175:diagnosis* / Q000628:therapy; D013997:Time Factors; D055815:Young Adult