Uncommon Tissue Defects of Upper Extremities: Bacillus Antracis

Introduction: Anthrax is a zoonotic disease caused by Bacillus anthracis spores. Cutaneous form is the most common and the least fatal form of the disease, however the disease is uncommon in Europe and U.S. and the reports in the literature are mostly case reports for upper extremity. Case Series: 7 patients, who were treated between 1999 and 2015 in our clinic with the diagnosis of cutaneous anthrax in their upper extremity, were included to our study. 3 patients applied directly to plastic surgery, others were consulted from the infectious disease clinics. Reconstructions were done with skin grafts or secondarily. Discussion: Anthrax causes cutaneous, gastrointestinal and inhalation forms of the disease. Despite being very rare in Europe and US, in Turkey there are many reported anthrax cases. However, cutaneous anthrax of upper extremity is reported rarely in the literature. Painless papule and vesicles are well defined as clinical findings. In anthrax, the excision of skin lesions or biopsies is contraindicated because of the risk of systemic spread. Conclusion: Despite cutaneous anthrax of the hand and upper extremity is very rare, the diagnosis is easy because of the typical presentation and history. Once the definitive diagnosis is set, the treatment is effortless with the antibiotherapy and first steps of the reconstruction ladder.