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A rare case of brucellosis with dermatomal pattern of cutaneous manifestation

Authors Gharebaghi N, Mehrno M, Sedokani A

Received 31 January 2019

Accepted for publication 12 June 2019

Published 11 July 2019 Volume 2019:12 Pages 223—228


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Ronald Prineas

Naser Gharebaghi,1 Mojhdeh Mehrno,Amin Sedokani2 

1Department of Infectious Disease, Faculty of Medicine, Urmia University of Medical Science, Urmia, Iran; 2Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran

Abstract: Brucellosis is a systemic disease which may involve any organ or system of the body, and is listed in the differential diagnosis of many diseases. In spite of described cutaneous involvements, skin manifestations are not common in brucellosis, particularly papulonodular lesions with dermatomal patterns that may overlap with dermatomal skin lesions. This may prevent correct diagnosis and treatment in practice, harming patients’ health and leading to financial costs to the health system and patient. In this case, at first, due to left thigh and buttock skin lesions and dermatomal pattern, the patient was diagnosed with Herpes zoster infection. After medical treatment and no improvement of lesions, the patient was referred to the infectious clinic with low back pain; magnetic resonance imaging (ordered by a neurosurgeon) suggested infectious spondylodiscitis. At the infectious ward, brucellosis spondylitis was diagnosed and a biopsy was taken from dermatomal lesions. The patient’s follow-up after 1, 2, and 3 months revealed that treatment of brucellosis had led to healing of lesions. Surprisingly, the histopathological assessment of the biopsy suggested psoriasis vulgaris. This was a rare case of manifestation of cutaneous brucellosis which could not even be diagnosed by histopathological assessment.

Keywords: brucellosis, cutaneous manifestations, dermatomal pattern, psoriasis

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