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A 22-year-old woman developed soft tender nodules on the right medial ankle and plantar foot at the beginning of pregnancy (Figure 1). She immigrated to Washington state from Mexico 18 months prior to the onset of symptoms. Analysis of biopsy specimens revealed small white-yellow grains extruded from the biopsy site. Mixed inflammation diffusely involved the dermis with deep dermal collections of filamentous basophilic rods (Figure 2). Magnetic resonance imaging demonstrated mycetoma and infectious myositis without evidence of osteomyelitis.
Yeh I, Dhanireddy S. Madura Foot Caused by Actinomadura madurae in a Pregnant Woman. Arch Dermatol. 2010;146(10):1189-1190. doi:10.1001/archdermatol.2010.296