Weeping Leg: An interesting presentation of Madura foot
The present case has been reported in BMJ. A 37-year-old daily wager presented with multiple painless small nodules and granules discharging sinuses over the left leg. The lesions were uniformly distributed below the knee up to the ankle crease. The skin was puckered and tethered to the underlying tissues.

However, the foot and thigh of the involved limb and rest of the other limbs were absolutely symptom free. Radiographs showed erosion of the entire tibia and fibula with mixed sclerotic and osteolytic areas along with sub tissue swelling and periosteal reactions.

The culture of the grains in Modified Sabouraud Agar media supplemented with 0.5% yeast extract revealed Madurella mycetomatis from its characteristic colony of fruiting bodies.

Learning points
• Mycetoma is diagnosed late due to painless nature of the disease and late presentation of the patient.

• Clinical suspicion should be made with the triad presentation of painless soft tissue lesion, draining sinuses and extrusion of grains even if not in foot which typically is seen in.

Read more here: http://casereports.bmj.com/content/2018/bcr-2018-225567.full
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