Therefore, more common skin conditions, like cellulitis, foreign body reaction, skin cancer, and fungal or parasitic infections, are often explored first. Overall, diagnosis and treatment of this rare skin infection is often delayed because of a lack of suspicion.Lab tests for finding M. marinum include cultures where a swab or sample is taken and grown in the laboratory. Cultures of M. marinum are fairly difficult to grow, and results may take several weeks. The culture may be negative, even if there is an active infection. Treatment may still be considered even if the test results are negative, especially if the patients history supports past fish or fish-tank exposure. In the absence of positive culture results, a skin or tissue biopsy may be a helpful test to render a microscopic diagnosis. Another technique that can be used to detect the bacteria is Polymerase Chain Reaction (PCR). A biopsy sample itself is sufficient to detect the exact type of bacteria by means of PCR. Prevention
Avoid fresh or saltwater activities if there are open cuts, scrapes, or sores on the skin, especially in water where this bacterium is known to exist. Wear heavy gloves (leather or heavy cotton) while cleaning or processing fish, especially fish with sharp spines that may cause cuts to the hands and skin. Wash hands thoroughly with soap and water after fish processing or use a waterless cleanser. Wear waterproof gloves while cleaning home aquariums or fish tanks.
Treatment
Surgery has been the most common form of treatment for both localized: 101 : 361  and diffuse TGCT. : 103 : 361 : 1  After surgery, patients may receive physical therapy in order to help rehabilitate affected joints. However, recurrence of TGCT after surgery is common, with a higher rate of recurrence for diffuse TGCT than for localized TGCT. : 361  In cases of recurrent or resistant disease, multiple surgeries, total joint arthroplasties, or amputation may be required. : 1 A multidisciplinary approach, supplementing surgery with radiotherapy or other treatments, can also improve outcomes in cases of recurrent TGCT. In the late 2010s, treatment with CSF1R inhibitors emerged as an option that may help improve functionality for patients with recurrent TGCT or TGCT that is not easily managed by surgery. : 361

Epidemiology
A study conducted in the Netherlands estimated that the worldwide incidence of TGCT is 43 cases per million person-years. The majority – 39 cases per million person-years – were estimated to be localized TGCT; the remaining 4 cases per million person-years were estimated to be diffuse TGCT. TGCT can occur in patients of any age, but people with localized TGCT are typically between 30 and 50 years old,: 100–101  while diffuse TGCT tends to affect people under the age of 40.: 102–103

See also
Fibroma of tendon sheath
List of cutaneous conditions

References


== External links ==