Rare skin manifestation of Mycobacterium marinum, lesion on shoulder: a case report

Mycobacterium marinum causes sporadic skin infection. It mostly appears on extremities with erythematous or bluish papule nodule at the inoculation site, usually after abrasions are exposed to contaminated water fish. A 43-year-old male patient no prior medical history noticed appearance of red lesions back his left shoulder 2 years earlier. Various physicians visited and misdiagnosed as contact dermatitis. Physical examination revealed polycyclic livid plaques irregular hyperkeratosis shoulder. Eventually it was reported he carried a fishing net near time appeared. So, suspicion marinum, biopsies were performed histopathology showed epidermis acanthosis parakeratosis. The dermis severe infiltration neutrophils lymphoplasma cells presence few giant poorly defined granulomas indicating acute chronic necrotizing granulomas. Within three weeks starting treatment oral clarithromycin, rifampin co-trimoxazole, signs improvement began. manifestation this disease its site involvement in very rare among previous case reports, so considered necessary be reported.