Sporotrichoid Primary Cutaneous Nocardiosis: A Rare Case of Isolated Upper-Limb Involvement in a Housewife.

Nocardiosis is a rare infection due to a ubiquitous, gram-positive, weakly acid-fast, filamentous, aerobic bacteria, that are usually responsible for opportunistic infection in immunocompromised patients. Less frequently, nocardiosis can affect immunocompetent patients, causing primary cutaneous infections. Here we present a case of a 45-year-old housewife with a 12-day history of red painful nodules arranged linearly on her right upper limb, without any apparent history of injuries or comorbidities, albeit with a hobby of gardening. The unusual yet characteristic presentation, microbiological findings, and excellent response to co-trimoxazole therapy were consistent with a diagnosis of sporotrichoid primary cutaneous nocardiosis. The uncommon lymphocutaneous presentation is often misdiagnosed. Therefore, keeping a high index of suspicion in such cases is important to improve the cure rate and prevent complications.

Pigmentary demarcation lines over the face.

BACKGROUND: We have been observing that a significant proportion of our patients, especially females, have certain pigmentary demarcation lines (PDL) over the face. However, systematic studies of the subject are lacking. AIMS: We categorized the different clinical patterns of facial PDLs in the Indian subpopulation and assessed their prevalence in this study. METHODS: About 4000 consecutive patients, both males and females, attending our skin clinic were examined for the presence of any pigmentary demarcation lines on the face, from October 1998 to February 2000. RESULTS: Out of the study population of 4037 patients, 243 (6%) were found to have demarcation lines on the face. The demarcation lines were far more common in women (9%) than in men (0.75%). These lines could be classified into three patterns that we would like to label as F, G, H as PDLs A to E have already been described. CONCLUSIONS: Pigmentary demarcation lines are fairly common in the Indian population especially amongst the females. Hormonal influences could possibly explain the female preponderance. Aggregation of cases within families or among close relatives suggests a genetic background.