An eight-year-old boy, born in Sierra Leone, who consulted the hospital Saint John of God in Sierra Leone for a tumor in the lower eyelid of the left eye with a time of evolution of about one month.
The father reported a history of contact with papaya leaves.
During the examination she presented a hard tumor occupying the two external thirds of the lower left eyelid, with ulcerations on the skin surface and mucosa of the eyelid.
There were also lymphadenopathies on both sides of the neck.
The rest of the examination showed no relevant data.
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The impossibility of performing microbiological cultures in the terrain to administer a systemic and local antibiotic coverage as the first therapeutic option in the case of an infectious process.
Amoxicillin/clavulanic acid was administered orally, and topical tobramycin and challenge.
But the most important symptom was the hard consistency of the tumor, along with regional lymph nodes that suggested a neoformative process.
Finally, contact with papaya made us consider the possibility of latex contact dermatitis exuding these fruits when green.
A skin biopsy was performed and sent to a referral hospital.
The anatomopathologicalstudy showed fibrin and polynuclear exudate in the superficial area of the ulcer and granulation tissue in the deep regions, where histiocytes with intranuclear giant inclusions cells of type were identified.
A focal nonspecific inflammatory reaction was observed in the deepest biopsy site.
SAP staining was negative.
The diagnosis was: ulcerated lesion with characteristics compatible with herpes virus infection, accompanied probably by bacterial superinfection.
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At three weeks, the lower eyelid tumor began to decrease in size, as well as induration, while ulcerations healed.
A month and a half, the repair was complete.
