case_images: PMC4260285_01
case_images: Dorsal aspect of hand showing swelling and multiple sinuses
case_images: ABR-3-225-g001.jpg
case_images: PMC4260285_01_ABR-3-225-g001.jpg
case_images: F1
case_images: Physical examination was normal except a swelling in the left hand that extended from wrist to metacarpophalangeal joint of all the fingers, along with multiple discharging sinuses at the dorsal and palmar aspects of the hand [Figures 1 and 2].
case_images: Palmar aspect of showing swelling and discharging multiple sinuses
case_images: ABR-3-225-g002.jpg
case_images: PMC4260285_01_ABR-3-225-g002.jpg
case_images: F2
case_images: Physical examination was normal except a swelling in the left hand that extended from wrist to metacarpophalangeal joint of all the fingers, along with multiple discharging sinuses at the dorsal and palmar aspects of the hand [Figures 1 and 2].
case_images: Histopathological study showing radiating filaments, surrounded by eosinophilic hyaline material
case_images: ABR-3-225-g003.jpg
case_images: PMC4260285_01_ABR-3-225-g003.jpg
case_images: F3
case_images: Finally, curettage and biopsy of the draining sinuses was made, which revealed many neutrophils with some colonies consisting of radiating filaments, surrounded by eosinophilic hyaline material creating a sun-ray pattern, similar to that of actinomycosis [Figure 3].
case_images: Photograph showing surgical debridement of the lesion
case_images: ABR-3-225-g004.jpg
case_images: PMC4260285_01_ABR-3-225-g004.jpg
case_images: F4
case_images: Hence, a diagnosis of primary actinomycosis of hand was made for which he was treated with surgical debridement [Figure 4] and intravenous and oral penicillin therapy for 6 months to which patient showed excellent response.