Successful treatment of localized cutaneous infection caused by Mycobacterium scrofulaceum with clarithromycin.

Cutaneous infection arising from Mycobacterium scrofulaceum, a nontuberculous mycobacteria, has rarely been reported, and most of the reported infections were disseminated forms in patients with AIDS or other immunocompromising illness. We describe an occurrence of localized mycobacterial skin infection caused by M. scrofulaceum in a previously healthy child that manifested as a red nodule on the cheek. A biopsy specimen of the lesion demonstrated granulomatous infiltration in the dermis. M. scrofulaceum was isolated from culture of a tissue specimen. Polymerase chain reaction amplified specific fragments for M. scrofulaceum. The patient was treated successfully with clarithromycin as monotherapy for 6 months, leading to complete healing without recurrence during a follow-up period of 2 years.

Infiltrative trichilemmal carcinoma treated with 5% imiquimod cream.

BACKGROUND: Trichilemmal carcinoma (TLC) is a rare cutaneous neoplasm that occurs in the sun-exposed skin of the elderly. Although the clinical behavior of TLC appears to be relatively indolent, wide excision or Mohs micrographic surgery is the recommended treatment owing to its locally aggressive growth. Recently, imiquimod has become an important part of the armamentarium in the treatment of nonmelanoma skin cancer. OBJECTIVE: This article serves to remind dermatologists that in addition to Mohs micrographic surgery and surgical excision, imiquimod 5% cream may have a role in the treatment of TLC. METHODS: In addition to a review of the literature, we present a case of TLC successfully treated with 5% imiquimod cream. CONCLUSION: Its nonsurgical approach and excellent cosmetic result make imiquimod 5% cream another promising therapeutic option for TLC, even though it is histologically infiltrative.