Cutaneous Actinomycosis
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A 33-year-old man was referred to our institution in 2015 with lesions on his left knee that had worsened over the course of several years. In 2010, at which time he had an unremarkable medical history, he was involved in a motor vehicle collision that resulted in several superficial soft-tissue bruises on his left knee and no associated fractures. Two years after the collision, the patient sought medical attention for skin thickening and several subcutaneous nodules smaller than 1 cm that had gradually developed on the medial and lateral sides of his knee and had subsequently disseminated to the thigh. The patient reported no fevers or other systemic symptoms.On physical examination during the current presentation, the left knee was noted to have edema, erythema, hyperpigmentation, hyperkeratinization and several indurated nodules with scabs and sinus tracts, but without purulence or granule secretion...

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