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Bollinger's original description was from the lung and not from the skin. Drs Harman and English are correct, and I apologize for the error.With regard to the remainder of their letter, at the opening of the "Comment" section of our article, we emphasized the clinical characteristics of mycetoma: draining sinuses, grains, and tumefaction. The reported case of botryomycosis illustrates that these clinical features may occur secondary to an infection of bacteria of the order Eubacteriales; in the differential diagnosis of mycetoma, botryomycosis must be considered with eumycotic and actinomycotic mycetoma. Indeed, there appears to be no difficulty accepting actinomycetes, which are bacteria, as a cause of mycetoma. Why should there be difficulty accepting Eubacteriales?We are aware, as pointed out by Drs Harman and English, that S pelletierii produces red grains. Also, though dark grains indicate eumycotic mycetoma, we are aware that certain true fungi, such as
Picou KA. Further Information on Mycetomas-Reply. Arch Dermatol. 1980;116(6):619. doi:10.1001/archderm.1980.01640300007003