ABSTRACT
Actinomycosis is a chronic suppurative and granulomatous bacterial infection most commonly involving the cervicofacial region, thorax and the abdomen. Cervicofacial infection is the most frequent presentation and this results when microorganism invading damaged oral mucosa following dental extraction or other mouth trauma, causing a painful, indurated cutaneous and soft tissue swelling. Actinomycosis on the face can mimic various infectious or inflammatory skin diseases and a high degree of clinical suspicion should be entertained. We report a rare case of cutaneous actinomycosis in a 63-year-old male who presented solitary firm nodule with purulent discharge and fistula on the right cheek. He denied any recent dental procedure or trauma to the area. Histopathologic findings showed acute and chronic inflammation with characteristic sulfur granules consisting of a granular basophilic center surrounded by a radiating zone of eosinophilic, hyaline, club-shaped projection.