Cutaneous anthrax of the hand: Some clinical observations

Context: Anthrax is a very rare disease in Europe and the United States. Aim: A case of cutaneous anthrax of the hand with a wide skin defect is presented and some clinical observations highlighted. Case Report: A 56-year-old male patient with cutaneous anthrax attended our infectious diseases department with a swelling up to the upper arm. An urgent fasciotomy was undertaken with a diagnosis of compartment syndrome. A black eschar had formed on the dorsal surface of the hand. A superficial tangential escharectomy was performed. Results: Viable fibrous tissue, about 4 to 5 mm in thickness over the extensor tendons, was found under the eschar. At the postoperative 2-year follow-up, remarkable healing was observed via skin grafting. Conclusions: Hand surgeons should be cautious against the compartment syndrome that may accompany cutaneous anthrax of the hand. A consistent viable fibrous tissue can be found below the eschar. The mechanism for the involvement of the hand dorsum needs further concern.