SUPERFICIAL SKIN DISEASE In addition to M. leprous (leprosy) and M. tuberculosis, two other mycobacteria, M. marine and unlearns can produce an uncommon type of skin infection. Both this mycobacterium have tempera-tore requirements below 37° C., accounting for limitation of infection to superficial areas of the skin, usually on the extremities. Visceral involvement does not occur.
Marine frequently referred to as M Bali. is a photochromogenic saprophyte first described as the cause of tuberculosis in marine fish. It is widely distributed in nature, occurring in soil and freshwater fish as •well. The temperature for optimal growth is 30° C. to 32° C. It has been implicated in rare epidemics of granulomatous skin disease traced to infected swimming pools, beaches of several of the Hawaiian Islands, and. more rarely, tropical fish aquariums. The granulomas occur at the site of minor abrasions’, most commonly on the elbows, but also on the knees, toes, fingers, dorsum of the feet. and bridge of the nose, appearing two to three weeks after infection thirteenth centuries, leprosy persists today in as papules or nodules that slowly increase in size and may ulcerate. Spontaneous healing is to be expected after several months.
Diagnosis may be established by culturing a biopsy of the lesion at 30° C. Histologically, the tissue usually suggests tuberculosis like a granuloma, but may appear to be a nonspecific chronic inflammatory reaction. A weakly positive tuberculin test (cross-sensitivity) may be found. No treatment is recommended. Disease resulting from M. ulcerans is quite rare.
SUPERFICIAL SKIN DISEASE agent, which grows best at 30 to 33° C., has been reported as the cause of indolent skin ulcerations in man. The lesions may be quite destructive and persistent and may require surgical excision. Bates, J. H.: A study of pulmonary disease associated with my-bacteria other than Mycobacterium tuberculosis: Clinical characteristics. Amer. Rev. Resp. Dis., 96:1151, 1967. Mackellar, A., Hilton, H. B., and Masters, P. L.. Mycobacteriallymphadenitis in childhood. Arch. Dis. Child., 42:70, 1967 Schaefer, W. B., and Davis, C. L.: A bacteriologic and history-pathologic study of skin granuloma due to Mycobacterium bathed. Amer. Rev. Resp. Dis., 84:837, 1961.Selon, J. B. “Atypical” mycobacterium: A review. Tubercle, 50 (Supp.):70, 1969.