Tenosynovitis with rice body formation presenting as a cutaneous abscess
Issue date
2014Author
Moreno, Sara
Forcada Calvet, Pau
Soria, Xavier
Altemir, Victoria
Gatius Calderó, Sònia
Gil, Mabel
Suggested citation
Moreno, Sara;
Forcada Calvet, Pau;
Soria, Xavier;
Altemir, Victoria;
Gatius Calderó, Sònia;
Gil, Mabel;
...
Martí Laborda, Rosa Ma..
(2014)
.
Tenosynovitis with rice body formation presenting as a cutaneous abscess.
Journal of Cutaneous Pathology, 2014, vol. 41, p. 602–605.
https://doi.org/10.1111/cup.12316.
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Show full item recordAbstract
A 62-year-old woman with a past medical history of rheumatoid
arthritis was referred to the Department of Dermatology because of an
enlarging cutaneous lesion on the right thumb which resembled a soft
tissue infection. She had received antibiotics without significant
improvement. Clinical examination revealed an erythematous nodule
involving almost the whole surface of the distal phalanx with
spontaneous drainage of countless of small yellowish ovoid granules.
Histopathologic study of these structures showed an inner core of
amorphous acidophilic material with some interspersed chronic
inflammatory cells and a surrounding thin fibrin layer. Special stains
and cultures were negative for parasites, bacterium and
mycobacterium. Magnetic resonance imaging (MRI) revealed
distension of the first and fifth finger flexor sheaths and common finger
flexor sheath. These areas were filled by fluid and multiple small
nodular lesions. A diagnosis of non-infectious rice body tenosynovitis
was rendered and surgical removal was performed. Total recovery was
observed with no evidence of recurrence after 6months of follow-up.
To our knowledge, this is the first report of rice body tenosynovitis
presenting as a pseudoinflammatory cutaneous lesion with evolution to
a cutaneous fistula with drainage of rice grain-like structures. The
description of this impressive and peculiar clinical and histopathologic
picture is important to further recognize similar cases.