Arch Aesthetic Plast Surg.  2017 Oct;23(3):155-158. 10.14730/aaps.2017.23.3.155.

Actinomycosis in a Mucosal Lesion on a Created Perioral Dimple: A Case Report

• Kim UG
• Kim CH
• Kwon KS
• Hwang E

• KMID: 2394323
• DOI: http://doi.org/10.14730/aaps.2017.23.3.155

Abstract

Facial dimple creation is a simple surgical procedure. Nonetheless, several complications can occur. Actinomycosis is a rare chronic granulomatous infection caused by Actinomyces species. Some conditions that can cause actinomycosis are trauma, oral surgery, and poor dental hygiene. We report a case of actinomycosis that developed on a created facial dimple. A 51-year-old woman presented with a palpable mass on her left cheek that was approximately 1 cm in size. She had undergone facial dimple-creating surgery on both perioral areas at a local clinic 12 years previously. She had not experienced any problems until she was diagnosed with rheumatoid arthritis and diabetes mellitus about 2 years previously, for which she took leflunomide and methotrexate. The mass was completely excised through an intraoral approach. The specimen was grossly described as a gray-yellow cystic mass containing non-absorbable suture material. The filamentous nature of the Actinomyces organisms was observed in dark-stained foci on a histologic examination, confirming the diagnosis of actinomycosis. Indwelling non-absorbable suture materials may increase the risk for opportunistic infections, such as actinomycosis, in immunocompromised patients. Therefore, plastic surgeons should be aware of a patient's general hygiene, immune condition, and medical history when using these materials.

Keyword

Actinomycosis; Immunosuppressive agents; Infection

MeSH Terms

Actinomyces
Actinomycosis*
Arthritis, Rheumatoid
Cheek
Diabetes Mellitus
Diagnosis
Female
Humans
Hygiene
Immunocompromised Host
Immunosuppressive Agents
Methotrexate
Middle Aged
Opportunistic Infections
Oral Hygiene
Plastics
Surgeons
Surgery, Oral
Sutures
Immunosuppressive Agents
Methotrexate
Plastics