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Case Report
2001:67:4;198-199
PMID: 17664741

Cysticercosis cellulose cutis

Arun C Inamadar1 , BR Yelikar2
1 Department of Dermatology, BLDEA'S Shri B.M. Patil Medical College, Bijapur- 586 103, India
2 Department of Pathology, BLDEA'S Shri B.M. Patil Medical College, Bijapur- 586 103, India

Correspondence Address:
Arun C Inamadar
Department of Dermatology, BLDEA'S Shri B.M. Patil Medical College, Bijapur- 586 103
India
How to cite this article:
Inamadar AC, Yelikar B R. Cysticercosis cellulose cutis. Indian J Dermatol Venereol Leprol 2001;67:198-199
Copyright: (C)2001 Indian Journal of Dermatology, Venereology, and Leprology

Abstract

A woman aged 30 years with solitary lesion of cysticercosis cellulose cutis is reported. Cutaneous cysticerci are often a pointer to the involvement of internal organs. Our patient was a pure vegetarian so, probable mode of infection may be ingestion of contaminated vegetables, where the practice of using pig feces as manure is prevalent.
Keywords: Cysticercosis

Introduction

Cysticercosis is infection by the larval stage of the pork tape worm Taenia solium. Cysticerci can develope in any organ within man, but are more commonly found in the skin, subcutaneous tissue, brain, or the eye and can be fatal.[1] The disease is most prevalent in countries where pigs feed on humn feces.[3]

A case of cysticercosis cellulose cutis in a pure vegetarian woman is reported here for its rarity.

Case Report

A woman aged 30 years presented with a 2 cm diameter rubbery papule over the right forearm. Excision biopsy was done and gross examination of the specimen showed spherical milky white cyst and fluid within on cutting. HPE revealed invaginated scolex with suckers and hooklets [Figure - 1] suggestive of cysticercosis cellulose cutis. Retrospective history revealed patient′s habit of eating raw vegetables.

Retrospective imaging investigations like skull x-ray and CT scan ruled out neural cysticercosis and ophthalmic examination including fundoscopy ruled out eye involvement. Patient was put on broad spectrum albendazole.

Discussion

Human infection with cysticercosis are due to ingestion of eggs in contaminated food or drink or by reverse peristalsis of eggs or proglottodes from the intestine to stomach.[2] Oncospheres hatched by eggs enter the general circulation and form cysts in various parts of the body. In skin and subcutaneous tissue the lesions are usually painless, rubbery nodules, more or less stationary and contain cysticerci. Their numbers vary from 1 to 100.[2],[3] Probable mode of infection in our pure vegetarian patient may be ingestion of contaminated vegetables, which are grown on pig feces as organic manure, an agriculture practice prevalent in north part of Karnataka.

Cutaneous cysticerci do not carry any risk to the patient′s health, but they are often a pointer to the involvement of internal organs, like brain which causes seizures.[4] In a series of 33 patients reported by Arora et al 27 patients with multiple cysts had involvement of brain.[5] In the present case there was no involvement of brain, probably indicating that solitary cysts will not be associated with internal organ cysticercosis.[5]

A positive diagnosis is established solely by incision and examination of the interior, where the parasite will be found.[3] In the present case too excision biopsy was confirmative of the diagnosis.

Search of the available Indian literature revealed only a few reports[5],[6] of cutaneous cysticercosis, hence the present communication.

References
1.
Sparkd AK, Neafie RC, Cannor DH. Cysticercosis in: Pathology of Tropical and Extraordinary Diseases. An Atlas (Ed: Binford CH and Cannor DH) Vol.2, Castle House Publications Ltd., London, 1979; 539-543.
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2.
Bryceson ADM, Hay RJ. Parasitic worms and protozoa, In: Textbook of Dermatology (Ed: Rook/Wilkinson/Ebling) Vol.2, 5th Edition, Blackwell Scientific Publications, Oxford, 1992;1242-1243.
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3.
Arnold HL, Odom RB, James WD. Parasitic infestations, stings, and bites. In: Andrews Diseases of the Skin: Clinical Dermatology, 8th Edition, WB Saunders Company, Philadelphia, 1990; 500-501.
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4.
Falanga V, Kapoor W. Cerebral cysticercosis : Diagnostic value of subcutaneous nodules. J Am Acad Dermatol 1985; 12: 304.
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5.
Arora PN, Sanchetee PC, Ramkrishan KR, et al. Cutaneous, mucocutaneous and neurocutaneous cysticercosis. Indian J Dermatol Venereol Leprol 1990; 56: 115-118.
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6.
Misra RS, Dharmapal, Bikhchandani R. A review of cysticercosis cellulose with two case reports. Indian 3 Dermatol Venereol Leprol 1970; 36: 164.
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