Three Distinct Episodes of Thumb Felon in a Fur Industry Worker.

Aims: To present and discuss the etiology of three distinct episodes of thumb felon in a fur industry worker, in association with the required precautions. Case Presentation: A 61-year-old man working in a fur industry was treated for three distinct episodes of a felon of the right thumb within an 8-month period. He was treated successfully with surgical drainage and antibiotics following each episode. He was symptom-free and returned to work about two months following each episode. Felon formation, in all cases, was due to a Streptococcus constellatus infection secondary to mink hair penetration through the distal nail groove of his thumb. Using protective gloves, no further relapses have occurred during a 5-year follow-up. Discussion: A felon is an abscess of the pulp of a finger or thumb usually due to percutaneous trauma. Streptococcus constellatus, which is included in the Streptococcus milleri group, is often associated with various pyogenic infections. In the reported case, the lack of hand protection during fur processing was the cause of mink hair infiltration into the pulp of the patient’s thumb through the distal nail groove and of the three episodes of felon formation due to the secondary infection by Streptococcus constellatus. Conclusion: Lack of hand protection during fur processing could make hands vulnerable to micro-injuries and secondary infections.

Acroosteolysis of Scleroderma Associated with a Felon / 대한정형외과학회잡지

The Scleroderma is a chronic inflammatory disease of the connective tissue with involvement of the skin and other organs. It can be a manifestation of various disorders and occasionally acroosteolysis in the phalanges. Acroosteolysis is characterized by bone resorption or destruction in the phalanges, while the base is preserved. The pathogenesis of acroosteolysis in patients with scleroderma is a blood-flow disorder that is mainly associated with an abnormal accumulation of collagen in all tissues, microangiopathy and infections in the phalanges. The phalanges in patients with scleroderma are prone to continuous infections as a felon or skin ulcers due to atrophy of the subcutaneous tissue, dry and sclerotic skin, or a disorder of the immune system. We experienced a patient who had acroosteolysis with scleroderma of the phalanges, and this was associated with a felon. We report on this case along with a brief review of the literature.