Ann Dermatol.  2011 Sep;23(Suppl 1):S131-S134. 10.5021/ad.2011.23.S1.S131.

Actinomycosis of the Upper Lip

• Lee YS
• Sim HS
• Lee SK

• KMID: 2156771
• DOI: http://doi.org/10.5021/ad.2011.23.S1.S131

Abstract

Actinomycotic infections are known to have an association with difficulties in diagnosis and treatment. These infections usually involve the head, neck, thorax, and abdomen. Actinomycosis of the upper lip is a rare condition and an important one as well, because it can imitate other diseases. As the initial impression, it can easily be mistaken for a mucocele, venous lake, or benign neoplasm. An 82-year-old man presented with an asymptomatic normal skin colored nodule on the upper lip. Histopathologic findings showed an abscess and sulfur granules in the dermis. Gram staining results showed a mesh of branching rods. In this report, we present an unusual case of actinomycosis of the upper lip and discuss its characteristics and therapeutic modalities.

Keyword

Actinomycosis; Sulfur granules

MeSH Terms

Abdomen
Abscess
Actinomycosis
Aged, 80 and over
Dermis
Head
Humans
Lakes
Lip
Mucocele
Neck
Skin
Sulfur
Thorax
Sulfur

Figure

• 

  Fig. 1 A normal skin colored subcutaneous nodule measuring 8 mm on the mucosal aspect of the right upper lip.

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  Fig. 2 (A) Sulfur granules associated with suppurative inflammation in the dermis (H&E, ×40). (B) The magnified view shows a group of filamentous bacteria forming a sulfur granule with peripheral Hoeppli-Splendore phenomenon (H&E, ×400).

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  Fig. 3 (A) No acid-fast-bacilli are seen (AFB, ×200). (B) A gram stain demonstrates numerous, radially oriented, gram-positive filamentous bacteria and peripheral clubs at its edge (Gram stain, ×400).

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