Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obervation Letter
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Studies
Study Letter
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Tables
Technology
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF
Quiz
2018:84:1;54-56
doi: 10.4103/ijdvl.IJDVL_582_16
PMID: 28474642

A red, swollen and painful lesion on the right hand after local steroid injections

Kaisheng Liao1 , Chienliang Fang2 , Chienchin Chen3
1 Department of Pathology, Ditmanson Medical Foundation Chiayi Christian Hospital; Department of Nursing, Chung-Jen College of Nursing, Health Sciences and Management, Chiayi, Taiwan
2 Department of Surgery, Division of Plastic Surgery, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
3 Department of Pathology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi; Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan, Taiwan

Correspondence Address:
Chienchin Chen
No. 539, Zhongxiao Road, East District, Chiayi 600
Taiwan
How to cite this article:
Liao K, Fang C, Chen C. A red, swollen and painful lesion on the right hand after local steroid injections. Indian J Dermatol Venereol Leprol 2018;84:54-56
Copyright: (C)2018 Indian Journal of Dermatology, Venereology, and Leprology

A 60-year-old woman with a history of trigger finger presented with a 2-week history of a swollen right middle finger. She had received local steroid injections twice for trigger finger 1 month before the visit. Unfortunately, the injection site became red, swollen and painful [Figure 1a]. No evidence of immunosuppression was proven by tests for human immunodeficiency virus, hepatitis B virus, hepatitis C virus and diabetes. She subsequently underwent local debridement. On incision, there was serosanguinous discharge and necrotic synovitis of the volar side of the right third metacarpal head region [Figure 1b]. Histopathological examination revealed numerous spore-like microorganisms in the necrotic debris [Figure - 2]. Numerous endospores with occasional floret-like arrangement were identified on periodic acid-Schiff and silver stains [Figure - 3]. Tissue cultures were set up on blood agar plate and Sabouraud dextrose agar. The wet mount revealed round-to-oval spores of varying sizes (about 10–20 μ) with varying number of endospores inside.

Figure 1a: The right hand showed local redness and inflammation
Figure 1b: On surgical exploration necrosis was observed
Figure 2: Spore-like microorganisms were found in necrotic debris (H and E, ×400)
Figure 3: The Periodic acid-Schiff stain revealed numerous spore-like microorganisms (×400). The endospores with typical floret-like arrangement are identified (inset)

Question

What is the diagnosis?



Click here to view answer. View Answer

References
1.
Todd JR, King JW, Oberle A, Matsumoto T, Odaka Y, Fowler M, et al. Protothecosis: Report of a case with 20-year follow-up, and review of previously published cases. Med Mycol 2012;50:673-89.
[Google Scholar]
2.
Nguyen QG, Rosen T. Cutaneous protothecosis in a patient with chronic lymphocytic leukemia: A case report and literature review. J Fungi 2015;1:4-12.
[Google Scholar]
3.
Hillesheim PB, Bahrami S. Cutaneous protothecosis. Arch Pathol Lab Med 2011;135:941-4.
[Google Scholar]
4.
Lass-Flörl C, Mayr A. Human protothecosis. Clin Microbiol Rev 2007;20:230-42.
[Google Scholar]

Fulltext Views
380

PDF downloads
120
Show Sections