[Cutaneous atypical mycobacteriosis due to Mycobacterium kansasii--a case report and a review of the literature].

A case of cutaneous atypical mycobacteriosis due to Mycobacterium (M.) kansasii is reported. A 41-year-old man, who had lived in Kawasaki city, was seen in April 1988 because of sores on the dorsum of left forefinger which had been present for one month. Physical examination revealed an erythematous, edematous plaque approximately 2 and 4 cm overlying proximal and middle phalanx of left index finger. Otherwise his physical findings were normal. Laboratory studies including X-ray examinations of the chest and left hand were normal. The histopathology revealed a mixed cellular infiltration consists of mononuclear cells and neutrophils with necrosis in the dermis. No granuloma formation was observed. In the deep dermis, some acid fast bacilli (AFB) were demonstrated. The culture for AFB was positive with the following characteristics: Acidfastness (+), Niacin (-), Photochromogenecity (+), Growth at 37 degrees C (+), at 42 degrees C (+), at 45 degrees C (-), Nitrate reduction (+), Catalase (+). These tests were diagnostic of Group I photochromogen, M. kansasii. We reviewed 19 cases of cutaneous atypical mycobacteriosis due to M. kansasii in the world literature including our case and found that there were three types of the disease: (1) Cutaneous chronic granulomatous type, (2) Disseminated acute pyogenic type and (3) Cutaneous pyogenic type.