Pott’s Puffy Tumor Caused by Chronic Sinusitis Resulting in Sinocutaneous Fistula

Abstract

not lead to troublesome cases of acne. 2 However, our experience in a referral center for GID has shown otherwise.Report of Cases | Case 1. A trans man in his 20s with a history of mild acne during adolescence presented with inflammatory acne with scarring in the face and chest of 4 months' duration that had not responded to topical retinoids. He had begun T therapy 6 months before (testosterone undecanoate, 1000 mg every 3 months), with adequate virilization that included facial hair growth and suppression of menses. Blood T levels were 505.6 ng/dL.He started treatment with oral isotretinoin (30 mg/d), and after 9 months, the acne had completely resolved. Three months after treatment was discontinued, the acne recurred and required retreatment with isotretinoin, 20 mg/d, which was ongoing at last follow-up with good response.Case 2. A trans man in his 20s with no relevant dermatologic history was referred for severe acne on his face and trunk and seborrhea, all of which had appeared 6 months after he began standard T treatment (testosterone undecanoate, 1000 mg every 3 months). The patient had developed secondary male characteristics, namely facial and body hair growth. His T levels after starting hormonal treatment were 496 ng/dL.He received treatment with isotretinoin, 20 mg/d, for 8 months with complete resolution of the acne but persistence of scarring. Six months after discontinuation of treatment, he presented with a new acne outbreak resistant to oral doxicycline that required retreatment with isotretinoin (20 mg, 3 times a week), which was ongoing at last follow-up with good response and tolerance.

Pott’s Puffy Tumor: A Potentially Deadly Complication of Sinusitis

“…The condition is important to diagnose early as complications of the "tumor" can result in meningitis, frontal lobe abscess, cavernous sinus thrombosis, and epidural or subdural abscess [4]. Symptoms can vary from headache, periorbital swelling, swelling of the forehead, to purulent drainage, cutaneous fistulas, altered mental status, and cranial nerve deficits but fever can be absent [4,5,7]. Diagnosis can be made with CT with IV contrast, however magnetic resonance imaging can be useful to characterize the extent of the disease [5].…”

“…Diagnosis can be made with CT with IV contrast, however magnetic resonance imaging can be useful to characterize the extent of the disease [5]. Management consists of early broadspectrum IV antibiotics with surgical intervention to drain abscess and debride tissue [4,5,7,8]. Intracranial spread may require neurosurgical intervention [8].…”

Not Your Typical Preseptal Cellulitis: A Case Report Of Pott’s Puffy Tumor

“…Percivall Potts, surgeon at St. Bartholomew's Hospital in London, first described Pott's puffy tumor (PPT) in 1760 as "a puffy circumscribed, indolent tumor of the scalp and a spontaneous separation of the pericranium, from the skull under such tumor" which he observed after head trauma [1,2]. Additional causes include acute sinusitis and rarely after an insect bite, cocaine abuse, dental infection or fibrous dysplasia [3].…”

Pott's Puffy tumor: The role of ultrasound, computed tomography and magnetic resonance imaging in diagnosis

“…The disorders in differantial diagnosis of forehead swelling and headache are soft tissue infections, sellulitis, haematomas, neoplasms (3) and Pott's Puffy tumor. Terui et al (9) described a case of PPT caused by chronic sinusitis eesulting in sinocutaneous fistula. Eugene et al present a case of nonHodgkin's lymphoma of the frontal sinus presenting as Pott's puffy tumour (10).…”