Red grain mycetoma of the scalp (Actinomadura pelletieri). A case report from India

Abstract

A case of red grain mycetoma on the scalp is described. The disease, caused by Actinomadura pelletieri, is extremely rare in this part of the world, and from India this is perhaps the first case with scalp involvement. The lesion showed satisfactory response to partial excision followed by chemotherapy with streptomycin.

Mycetoma is a clinical syndrome of localized indolent deforming tumid lesions and sinuses involving the cutaneous and subcutaneous tissues (8). The disease is caused by two groups of agents; one bacterial and the orher fungal and is accordingly classified as actinomycotic and eumycotic mycetoma respectively. The lesions discharging fungal microcolonies referred to as ‘grains’ usually occur on the foot or the hand. Occasionally, the lesions have been seen on the axillary (3) and the thoracocervical region (6). The involvement of the scalp is extremely rare. Reddy et al (7) in their study of 50 cases from Southern India, found only one instance of a scalp infection, the causative agent being A. madurae. We report herein on a patient with classical lesions of mycetoma on the scalp as a result of Actinomadura pelletieri infection.