Diagnostic & Therapeutic Challenges of Actinomycosis: A Benign Speck Masquerading as a Soft Tissue Malignancy Actinomycosis is a chronic infection caused by filamentous gram-positive anaerobes, typically presenting in cervicofacial regions. We report a rare case involving the lower limb of an immunocompetent male, initially suspected to have soft tissue sarcoma based on imaging. The diagnosis was confirmed histologically with characteristic sulfur granules and the Splendore-Hoeppli phenomenon. Despite antibiotic therapy, non-compliancy led to disease progression and necessitated a below-knee amputation. This case emphasises the importance of early diagnosis, patient compliance, and a multidisciplinary approach in managing rare infections mimicking malignancies.
Actinomycosis.

This is a report of a patient who presented with a history of what resembled a skin-tag on the plantar aspect of his left foot, which later grew in four months, causing discomfort during ambulation. Little did we know that the growth was just the tip of the iceberg of a vicious malignant melanoma (MM) lurking underneath with metastasis. Upon clinical suspicion, a biopsy was scheduled to obtain histopathological examination (HPE). Magnetic resonance imaging (MRI) reported the lesion to be a malignant melanoma and contrast enhance computed tomography of the thorax abdomen and pelvic (CECT TAP) surveillance and positron-emission tomography (PET) were requested to stage and guide the treatment modalities. A wide surgical resection was performed and wound was left to heal via secondary intention. The aim of this report is to create awareness of early suspicions and detection of MM and treatment, which could lead to a better prognosis and the acceptance of post excision allowing for wound to heal via secondary intention healing.
Melanoma ; Early Diagnosis ; Biopsy ; Prognosis